Long-term outcome and bridging success of patients evaluated and bridged to lung transplantation on the ICU

Gan, C. Tji-Joong; Hoek, Rogier A.S.; Bij, Wim van der; Wauwer, Caroline Van De; Erasmus, Michiel E.; Lansink-Hartgering, Annemiek Oude; Droogh, Joep M; Seghers, Leonard; Mathot, Bas J.; Mahtab, Edris A F; Bekkers, Jos A.; Miranda, Dinís Dos Reis; Verschuuren, Erik; Hellemons, Merel E.

doi:10.1016/j.healun.2022.01.017

Cited by 5 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study results of ECMO-BTT rate of 56% (25 out of 45 patients) and 1-year post-transplant survival of 92% are encouraging and emphasize the importance of an individualized approach to patient selection for ECMO as a bridge therapy for those with end-stage lung diseases. Moreover, our study results corroborate the findings of Gan et al : very sick patients can be bridged to transplant with ECMO (or mechanical ventilation) and have positive long-term outcomes ( 12 ).…”

Section: Discussionsupporting

confidence: 91%

“…Offering bridge therapy to such a sick patient population does come with the risk of complications but it brings the possibility of getting transplant without which death is certain for them. Emerging data do suggest that previously considered sick patients could be potential transplant recipients with use of ECMO as a bridge therapy ( 12 , 15 , 16 ) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Expanded extracorporeal membrane oxygenation bridge to heart and lung transplant candidate selection does not impact outcomes compared to traditional candidate selection criteria

Wahab¹,

Hanson²,

Peters³

et al. 2023

J Thorac Dis

View full text Add to dashboard Cite

Extracorporeal membrane oxygenation is used as a bridge to transplant (ECMO-BTT) in selected patients. The objective of this study was to determine whether 1-year post-transplant and post-ECMO survival are impacted by traditional compared to expanded selection criteria. We performed a retrospective study of patients >17 years who received ECMO as bridge to transplant (BTT) or bridge to transplant decision for lung or combined heart and lung transplantation at the Mayo Clinic Florida and Rochester. Institutional protocol excludes patients >55 years, maintained on steroids, unable to participate in physical therapy, with body mass index >30 or <18.5 kg/m 2 , non-pulmonary end-organ dysfunction, or unmanageable infections from ECMO-BTT. For this study, adherence to this protocol was considered traditional whereas exceptions to the protocol were considered expanded selection criteria. A total of 45 patients received ECMO as bridge therapy. Out of those 29 patients (64%) received ECMO as bridge to transplant and 16 patients (36%) as bridge to transplant decision. The traditional criteria cohort consisted of 15 (33%) patients and expanded criteria cohort consisted of 30 (67%) patients. In the traditional cohort, 9 (60%) of 15 patients were successfully transplanted compared to 16 (53%) of 30 patients in the expanded criteria cohort. No difference in being delisted or dying on the waitlist (OR: 0.58, CI: 0.13–2.58), surviving to 1-year post-transplant (OR: 0.53, CI: 0.03–9.71) or 1-year post-ECMO (OR: 0.77, CI: 0.0.23–2.56) was observed between the traditional criteria and expanded criteria cohorts. At our institution, we did not see differences in odds of 1-year post-transplant and post-ECMO survival between those who met traditional criteria compared to those who did not. Multicenter, prospective studies are needed to evaluate the impact of ECMO-BTT selection criteria.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Expanded extracorporeal membrane oxygenation bridge to heart and lung transplant candidate selection does not impact outcomes compared to traditional candidate selection criteria

Wahab¹,

Hanson²,

Peters³

et al. 2023

J Thorac Dis

View full text Add to dashboard Cite

show abstract

“…A recently published study demonstrates that patients transplanted after urgent expedited LTX evaluation in an ICU setting can have comparable survival to patients transplanted electively from home. 32 However, it is often infeasible to complete the evaluation in such a situation, as these patients often have very high oxygen requirements. Furthermore, the mainstay of therapy for AE-IPF is high-dose corticosteroids, which can raise the risk of anastomotic complications after LTX.…”

Section: Discussionmentioning

confidence: 99%

Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplant Outcomes

Warrior,

Sayad,

O’Hara

et al. 2024

Transplantation

View full text Add to dashboard Cite

Background. Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are acute, significant respiratory deteriorations in patients with IPF and can lead to increased morbidity and mortality. It remains unclear how AE-IPF impacts lung transplant (LTX) outcomes. Methods. All adult patients who were listed for LTX between July 2005 and October 2020 at the Loyola University Medical Center with a diagnosis of IPF were included. Pretransplant characteristics and posttransplant outcomes were gathered via retrospective chart review. The primary outcome was short- and long-term survival for patients transplanted during stable IPF versus those with AE-IPF. Results. One hundred fifty-nine patients were included in this study, 17.6% of whom were transplanted during AE-IPF. AE-IPF patients were more likely to have higher oxygen needs pretransplant, have higher lung allocation score, and were more likely to be intubated or be on extracorporeal membrane oxygenation as compared with stable IPF patients. Survival by AE status at transplant did not differ at 90 d or 1 y posttransplantation. There were also no significant differences in rates of severe primary graft dysfunction or acute rejection within 1 y. Conclusions. Patients with AE-IPF were more likely to have higher oxygenation requirements and higher lung allocation score at the time of LTX than those with stable IPF. Despite this, there were no differences in survival at 90 d, 1 y, or 3 y, or differences in incidence of severe primary graft dysfunction or acute cellular rejection. Transplantation of patients with AE-IPF has clinical outcomes comparable with transplantation of patients with stable IPF. This contrasts with previous studies examining LTX in patients with AE-IPF.

show abstract

The Lung Transplant Candidate, Indications, Timing, and Selection Criteria

Mannem

Aversa

Keller

et al. 2023

Clinics in Chest Medicine

View full text Add to dashboard Cite

Long-term outcome and bridging success of patients evaluated and bridged to lung transplantation on the ICU

Cited by 5 publications

References 27 publications

Expanded extracorporeal membrane oxygenation bridge to heart and lung transplant candidate selection does not impact outcomes compared to traditional candidate selection criteria

Expanded extracorporeal membrane oxygenation bridge to heart and lung transplant candidate selection does not impact outcomes compared to traditional candidate selection criteria

Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplant Outcomes

The Lung Transplant Candidate, Indications, Timing, and Selection Criteria

Contact Info

Product

Resources

About