Contemporary Outcomes of Extracorporeal Membrane Oxygenation Used as Bridge to Lung Transplantation

Hakim, Ali H.; Ahmad, Usman; McCurry, Kenneth R.; Johnston, Douglas R.; Pettersson, Gösta; Budev, Marie; Murthy, Sudish C.; Blackstone, Eugene H.; Tong, Michael Z.

doi:10.1016/j.athoracsur.2018.02.036

Cited by 75 publications

(76 citation statements)

References 14 publications

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“…Hakim et al showed an 87% success rate in survival to transplantation in patients placed on ECMO as BTT. 47 One-year and 3-year survival in this cohort were 85% and 80%, respectively, which is comparable to nationally published lung transplantation survival data of 82% (1-year) and 69% (3-year) for bilateral lung recipients. 48 Extracorporeal membrane oxygenation as BTT is considered for potential transplant candidates with rapid deterioration in pulmonary function that is refractory to medical management.…”

Section: Ecmo For Lung Transplantationsupporting

confidence: 84%

Extracorporeal Membrane Oxygenation: The New Jack-of-All-Trades?

Kwak

Majewski

Jellish

2020

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Ecmo For Lung Transplantationsupporting

confidence: 84%

Extracorporeal Membrane Oxygenation: The New Jack-of-All-Trades?

Kwak

Majewski

Jellish

2020

Journal of Cardiothoracic and Vascular Anesthesia

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“…Otherwise, the outcomes of awake ambulatory ECMO and spontaneous breathing can be excellent. [5][6][7][8][9] Although the experience with ECMO as a bridge to lung transplant is encouraging, there is limited evidence to use ECMO as a bridge to HLT. A previous analysis by Sertic et al 3 reported 50% mortality at 30 days and 50% mortality at 1 year in patients requiring ECMO before HLT.…”

Section: Discussionmentioning

confidence: 99%

Peripheral femoral venoarterial extracorporeal membrane oxygenation as bridge to heart‐lung transplant omne iter incipit primus

et al. 2020

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Heart‐lung transplant (HLT) is a widely accepted modality for certain patients with advanced and refractory cardiopulmonary disease. Some of these patients are critically ill on the transplant waiting list, and venoarterial extracorporeal membrane oxygenation (VA‐ECMO) can be used as a bridge to transplantation. Although the experience with ECMO as a bridge to lung transplant is promising, there is limited evidence to use ECMO as a bridge to HLT. Femoral cannulation remains a concern for ambulation given the risk of bleeding and cannula complications despite studies reporting its safety. We present a case of a 56‐year‐old male with interstitial lung disease and severe secondary pulmonary hypertension, who was successfully bridged to HLT with ambulatory femoral VA‐ECMO.

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“…Also, the cannulation technique in our study was different from other studies. In the Cleveland group, advances in cannula design that facilitate gait (double lumen single cannula) have been used, and positioning the cannulas in the upper extremities helping gait; in their cohort, 26% (5 of 19) were successfully gait during awake ECMO [29]. Unfortunately, double lumen single catheters are not available in South Korea, and therefore we had no alternative to femoral catheterization, which may interfere with gait during awake ECMO.…”

Section: Discussionmentioning

confidence: 99%

The Role of Awake Extracorporeal Membrane Oxygenation as Bridging Therapy for Lung Transplantation: A Retrospective Cohort Study

Kim¹,

Kim²,

Leem³

et al. 2020

Preprint

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Background As lung transplantation (LTx) becomes a standard treatment for end-stage lung disease, bridging to LTx with extracorporeal membrane oxygenation (ECMO) is increasing during waiting time, for either rescue treatment or improving ability to rehabilitation before transplant. This study investigated post-operative outcomes in patients bridging to lung transplantation with ECMO, especially those receiving awake ECMO. Methods In this single-center study, we retrospectively reviewed 241 consecutive LTx patients between October 2012 and March 2019. Among them, 65 patients received ECMO support while waiting for LTx; these patients were analyzed according to their awakeness. Multivaribale logistic regression and Cox proportional hazard models were used to analyze variables associated awake strategy and mortality. Results Thirty-three patients (50.7%) were awake during bridging ECMO, and 32 patients (49.2%) were in sedative status. The median age of awake ECMO patients was 59.0 (IQR 54.0-63.0) years, and 63.1% of population was male. There were no significant differences between awake and non-awake ECMO patients with respect to age, comorbidities, APACHE II score, ECMO duration and ECMO blood flow. Awake group have better post-operative outcome in terms of statically shorter post-operative intensive care unit (ICU) length of stay (LOS) (awake vs. non-awake, 6 [4-9.5] vs. 16 [6-22], p = 0.004) and longer ventilator free days (VFDs) (awake vs. non-awake, 24 [11.0-25.0] vs. 0 [0.0-14.5], p = 0.001). Furthermore, the awake ECMO group had a significantly lower six-month mortality rate compared to the non-awake group (18.2% vs. 40.6%, p = 0.045). It was independent predictive factor for ability to gait after LTx ([OR] 4.128, 95% CI 1.094-15.572, p = 0.036). Conclusions Awake ECMO therapy could be useful for high-risk patients waiting for LTx, and might help shorten ICU LOS and improve survival benefit after LTx. Furthermore, awake ECMO was independent predictive factor for postoperative gaiting.

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Contemporary Outcomes of Extracorporeal Membrane Oxygenation Used as Bridge to Lung Transplantation

Cited by 75 publications

References 14 publications

Extracorporeal Membrane Oxygenation: The New Jack-of-All-Trades?

Extracorporeal Membrane Oxygenation: The New Jack-of-All-Trades?

Peripheral femoral venoarterial extracorporeal membrane oxygenation as bridge to heart‐lung transplant omne iter incipit primus

The Role of Awake Extracorporeal Membrane Oxygenation as Bridging Therapy for Lung Transplantation: A Retrospective Cohort Study

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