Abstract
OBJECTIVE:To report initial experience from the use of extracorporeal membrane oxygenation (ECMO) in patients who received lung transplantation.METHODS:Retrospective study of a single tertiary center in the Brazilian state of São Paulo, a national reference in lung transplantation, based on the prospective collection of data from electronic medical records. The period analyzed extended from January 2009 (beginning of the program) until December 2018.RESULTS:A total of 75 lung transplants were performed, with ECMO used in 8 (10.7%) cases. Of the patients, 4 (50%) were female. The mean age was 46.4±14.3 years. The causes of the end-stage lung disease that led to transplantation were pulmonary arterial hypertension in 3 (37.5%) patients, bronchiectasis in 2 (25%) patients, pulmonary fibrosis in 2 (25%) patients, and pulmonary emphysema in 1 (12.5%) patient. In our series, 7 (87.5%) cases were sequential bilateral transplantations. Prioritization was necessary in 4 (50%) patients, and in 1 patient, ECMO was used as a bridge to transplantation. The ECMO route was central in 4 (50%), peripheral venovenous in 2 (25%) and peripheral venoarterial in 2 (25%) patients. The mean length of the intensive care unit (ICU) stay was 14±7.5 days and of the hospital stay was 34.1±34.2 days. The mean ECMO duration was 9.3±6.6 days with a 50% decannulation rate. Three patients were discharged (37.5%).CONCLUSION:Lung transplantation requires complex treatment, and ECMO has allowed extending the indications for transplantation and provided adjuvant support in the clinical management of these patients.
Highlights
Lung transplantation is a treatment alternative for endstage lung diseases
According to the International Society of Heart and Lung Transplantation (ISHLT), the number of transplants and survival have both increased over the years [1]
There has been a concomitant appearance of new technologies in thoracic surgery that have led to new patient support techniques, such as ex vivo lung perfusion [2], reconditioning of borderline lungs and donor lungs after
Summary
Lung transplantation is a treatment alternative for endstage lung diseases. According to the International Society of Heart and Lung Transplantation (ISHLT), the number of transplants and survival have both increased over the years [1]. There has been a concomitant appearance of new technologies in thoracic surgery that have led to new patient support techniques, such as ex vivo lung perfusion [2], reconditioning of borderline lungs and donor lungs after. Received for publication on December 28, 2019. Accepted for publication on March 18, 2020
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