RESULTS OF LUNG TRANSPLANTATION ASSISTED WITH EXTRACORPOREAL MEMBRANE OXYGENATOR (ECMO)

Abstract

Abstract INTRODUCTION According to the registry of the “International Society for Heart and Lung Transplantation” (ISHLT), 32% of lung transplants (Tx P) will require respiratory assistance in the perioperative period. The aim of the study is to compare the results of the Tx P that required ECMO, versus those that did not require respiratory assistance. MATERIAL AND METHODS Between January 2015 and December 31th 2018, 184 lung transplants were performed in the organ transplant unit. In 119 (64.7%) of the transplants, they did not need respiratory assistance and in 65 (35.3%) they required ECMO either intraoperatively and/or postoperatively. The indications for lung transplantation were: interstitial fibrosis 77 (41.8%), pulmonary emphysema 64 (34.7%), cystic fibrosis 28 (15.3%), others 15 (8.2%). RESULTS Patients with Mean Pulmonary Pressure (MPP) greater than 54 mmHg required assistance with ECMO during transplantation (p < 0.03). 83% of transplanted patients remained in NYHA grade I and grade II. Hospital mortality was 21/184 (11.4%); ECMO mortality 14/67 (20.9%) vs NO-ECMO mortality 6/117 (5.1%), significantly higher (p < 0.005 OR = 4.98). Survival and quality of life at 5 years were similar in both groups (p = 0.09). CONCLUSIONS ECMO has proven to be safe and effective in Tx P. Patients with PMP> 54 mmHg required ECMO (p < 0.03). After the hospital postoperative period, the quality of life and survival at five years were similar in both groups.