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Cited by 115Transplantation: Methods and OutcomesMechanical Circulatory Support DevicesCardiac and Coronary Surgery Techniques

The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.

Five-year experience with intraoperative extracorporeal membrane oxygenation in lung transplantation: Indications and midterm results

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Ius, Fabio, Sommer, Wiebke, Tudorache, Igor, Avsar, Murat, Siemeni, Thierry, Salman, Jawad, Molitoris, Ulrich, Gras, Clemens, Juettner, Bjoern, Puntigam, Jakob, Optenhoefel, Joerg, Greer, Mark, Schwerk, Nicolaus, Gottlieb, Jens, Welte, Tobias, Hoeper, Marius M., Haverich, Axel, Kuehn, Christian, Warnecke, Gregor·2016·The Journal of Heart and Lung Transplantation
DOI 10.1016/j.healun.2015.08.016
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Abstract

Background Since April 2010, extracorporeal membrane oxygenation (ECMO) has replaced cardiopulmonary bypass for intraoperative support during lung transplantation at our institution. The aim of this study was to present our 5-year experience with this technique.Methods Records of patients who underwent transplantation between April 2010 and January 2015 were retrospectively reviewed. Patients who underwent transplantation without ECMO formed Group A. Patients in whom the indication for ECMO support was set a priori before the beginning of the operation formed Group B. The remaining patients in whom the indication for ECMO support was set during transplantation formed Group C.Results Among 595 patients, 425 (71%) patients (Group A) did not require intraoperative ECMO; the remaining 170 (29%) patients did. Among these patients, 95 (56%) patients formed Group B, and the remaining 75 (44%) patients comprised Group C. Pulmonary fibrosis and pre-operative dilated or hypertrophied right ventricle emerged as risk factors for the indication of non-a priori intraoperative ECMO. Patients in Groups B and C showed a higher pre-operative risk profile and higher prevalence of post-operative complications than patients in Group A. Overall survival at 1 year was 93%, 83%, and 82% and at 4 years was 73%, 68%, and 69% in Groups A, B, and C (p = 0.11). The intraoperative use of ECMO did not emerge as a risk factor for in-hospital mortality or mortality after hospital discharge.Conclusions Intraoperative ECMO filled the gap between pre-operative and post-operative ECMO in lung transplantation. Although complications and in-hospital mortality were higher in patients who received ECMO, survival was similar among patients who underwent transplantation with or without ECMO.

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  • Several reports have demonstrated higher rates of grade 3 primary graft dysfunction among patients who underwent BOLT with versus without ECMO support.

    “While VA ECMO offers hemodynamic stability and adequate gas exchange, and facilitates controlled allograft reperfusion,3,8,18,28 several reports have demonstrated higher rates of grade 3 PGD among patients who underwent BOLT with versus without ECMO support.9,10,13”

    From Textbook outcome in lung transplantation: Planned venoarterial extracorporeal membrane oxygenation versus off-pump support for patients without pulmonary hypertension (2022) · cites this paper as [10]

    Table 3 (p. 5) reports higher rates of combined grade 2–3 primary graft dysfunction at 24 and 48 hours in the ECMO groups than in the no-ECMO group. It does not report grade 3 separately, and the comparison includes some single-lung transplant recipients rather than only patients who underwent BOLT. (LLM, conf=0.88)

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  • Previously reported associations between planned VA ECMO and increased grade 3 primary graft dysfunction are likely confounded by differences in underlying physiology and illness severity between planned support groups.

    “In this context, our findings suggest that previously reported associations between planned VA ECMO and increased grade 3 PGD are likely confounded by differences in underlying physiology and illness severity between planned support strata.”

    From Textbook outcome in lung transplantation: Planned venoarterial extracorporeal membrane oxygenation versus off-pump support for patients without pulmonary hypertension (2022) · cites this paper as [10]

    Table 3 (p. 5) reports more grade 2–3 PGD in the planned-ECMO group than in the no-ECMO group, and the Discussion (p. 6) notes that ECMO recipients had higher pre-operative risk and that complications could reflect either recipient risk or ECMO itself. The paper does not isolate grade 3 PGD or planned VA ECMO, nor does it conclude that their association is likely confounded by differences between support groups. (LLM, conf=0.84)

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Metadata

Authors
Ius, F., Sommer, W., Tudorache, I., Avsar, M., Siemeni, T., Salman, J., Molitoris, U., Gras, C., Juettner, B., Puntigam, J., Optenhoefel, J., Greer, M., Schwerk, N., Gottlieb, J., Welte, T., Hoeper, M. M., Haverich, A., Kuehn, C., & Warnecke, G.
Affiliations
  • Medizinische Hochschule Hannover (DE)
  • German Center for Lung Research (DE)
Corresponding author
Warnecke, Gregor
ORCID
Venue
The Journal of Heart and Lung Transplantation
Publisher
Elsevier BV
Published
2016-01
Volume
35
Issue
1
Pages
49-58
ISSN
1053-2498 (ISSN-L)
DOI
10.1016/j.healun.2015.08.016
OpenAlex
W1827789828
Cited by
115
References
25
Citations by year
2026: 4 · 2025: 5 · 2024: 11 · 2023: 10 · 2022: 15 · 2021: 18 · 2020: 14 · 2019: 9 · 2018: 7 · 2017: 17 · 2016: 5
FWCI
9.73
Type
journal article
Language
en
Open access
Licence
Locations
  • The Journal of Heart and Lung Transplantation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Mechanical Circulatory Support Devices
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords
extracorporeal membrane oxygenation, lung transplantation, intraoperative ECMO, cardiopulmonary bypass, ECMO indications, pulmonary fibrosis, right ventricular hypertrophy, postoperative complications, survival outcomes, in-hospital mortality
MeSH terms
Adult, Female, Follow-Up Studies, Germany, Humans, Intraoperative Care, Lung Diseases, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Time Factors, Extracorporeal Membrane Oxygenation, Incidence, Survival Rate, Lung Transplantation, Treatment Outcome, Hospital Mortality

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