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Cited by 47Transplantation: Methods and OutcomesMechanical Circulatory Support DevicesOrgan Transplantation Techniques and Outcomes

The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.

Long-term outcomes after intraoperative extracorporeal membrane oxygenation during lung transplantation

Open access
Ius, Fabio, Aburahma, Khalil, Boethig, Dietmar, Salman, Jawad, Sommer, Wiebke, Draeger, Helge, Poyanmehr, Reza, Avsar, Murat, Siemeni, Thierry, Bobylev, Dmitry, Optenhoefel, Joerg, Wiesner, Olaf, Greer, Mark, Schwerk, Nicolaus, Hoeper, Marius M., Welte, Tobias, Haverich, Axel, Kuehn, Christian, Warnecke, Gregor, Gottlieb, Jens, Tudorache, Igor·2020·The Journal of Heart and Lung Transplantation
DOI 10.1016/j.healun.2020.04.020
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Abstract

Introduction Over the past decade, extracorporeal membrane oxygenation (ECMO) has replaced cardiopulmonary bypass (CPB) for cardiopulmonary support during lung transplantation at our institution. In this study, we present our experience using intraoperative ECMO in isolated lung transplantation and evaluate its impact on long-term graft function and survival.Methods All patients undergoing isolated lung transplantation with or without ECMO support between January 2010 and June 2019 were evaluated. Patients transplanted using CPB were excluded. Peri-operative and follow-up results from our database and patient charts were analyzed. Follow-up continued until September 1, 2019 (median, 3.34 years).Results In total, 311 of 1,161 lung transplant recipients (27%) received intraoperative ECMO, with 24 (2%) patients further requiring CPB. None of the remaining 826 (71%) patients required intraoperative cardiopulmonary support. ECMO patients exhibited higher pre-transplant surgical risk profiles and endured more complicated early post-operative courses than those without ECMO (in-hospital mortality, 10.9% vs 2.3%; p < 0.001). Inevitably, this resulted in poorer overall graft survival among ECMO recipients (p = 0.0025). However, correcting for patients surviving to hospital discharge, no difference in survival between groups was observed (5-year survival, 71% vs 72%; p = 0.56). Similarly, freedom from chronic lung allograft dysfunction, biopsy-confirmed cellular rejection, or need for pulsed-steroid therapy did not differ between the groups (p = 0.99, p = 0.78, and p = 0.93, respectively).Conclusions Compared with patients not requiring cardiopulmonary support, ECMO recipients endured a more complicated peri-operative and early post-operative course. However, among those surviving to hospital discharge, no differences in long-term complications or outcomes were observed.

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Crossref · 10.1016/j.healun.2020.04.020

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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 [13]

    The PGD results (p. 3) report higher grade 3 PGD rates at 24, 48, and 72 hours with intraoperative ECMO than without it. However, the comparison covers isolated lung transplants as a group, including some single-lung transplants (Table 2, p. 5); the paper does not report this PGD comparison specifically for BOLT patients. (LLM, conf=0.85)

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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 [13]

    The PGD section (p. 3) reports more grade 3 PGD after intraoperative ECMO than without ECMO, and the Results (p. 1) describe higher pre-transplant risk among ECMO recipients. The paper does not establish that the association is confounded by differences between planned VA ECMO support groups; its comparison is intraoperative ECMO versus no intraoperative support. (LLM, conf=0.84)

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Metadata

Authors
Ius, F., Aburahma, K., Boethig, D., Salman, J., Sommer, W., Draeger, H., Poyanmehr, R., Avsar, M., Siemeni, T., Bobylev, D., Optenhoefel, J., Wiesner, O., Greer, M., Schwerk, N., Hoeper, M. M., Welte, T., Haverich, A., Kuehn, C., Warnecke, G., Gottlieb, J., & Tudorache, I.
Affiliations
Medizinische Hochschule Hannover (DE)
Corresponding author
Ius, Fabio
ORCID
Venue
The Journal of Heart and Lung Transplantation
Publisher
Elsevier BV
Published
2020-09
Volume
39
Issue
9
Pages
915-925
ISSN
1053-2498 (ISSN-L)
DOI
10.1016/j.healun.2020.04.020
OpenAlex
W3020872105
Cited by
47
References
27
Citations by year
2026: 3 · 2025: 6 · 2024: 9 · 2023: 8 · 2022: 14 · 2021: 6 · 2020: 1
FWCI
6.64
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 › Organ Transplantation Techniques and Outcomes
Keywords
extracorporeal membrane oxygenation, lung transplantation, intraoperative ECMO, cardiopulmonary bypass, graft survival, chronic lung allograft dysfunction, T cell-mediated rejection, postoperative mortality, long-term outcomes, perioperative complications
MeSH terms
Adult, Female, Follow-Up Studies, Humans, Intraoperative Care, Male, Middle Aged, Retrospective Studies, Time Factors, Extracorporeal Membrane Oxygenation, Lung Transplantation, Treatment Outcome

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