Pregled bibliografske jedinice broj: 1229966
Midterm outcomes of venovenous extracorporeal membrane oxygenation as a bridge to lung transplantation: Comparison with nonbridged recipients
Midterm outcomes of venovenous extracorporeal membrane oxygenation as a bridge to lung transplantation: Comparison with nonbridged recipients // Journal of Cardiac Surgery, 37 (2022), 4; 747-759 doi:10.1111/jocs.16253 (međunarodna recenzija, članak, znanstveni)
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Naslov
Midterm outcomes of venovenous extracorporeal
membrane oxygenation as a bridge to lung
transplantation: Comparison with nonbridged
recipients
Autori
Sef, Davorin ; Verzelloni Sef, Alessandra ; Trkulja, Vladimir ; Raj, Binu ; Lees, Nicholas J. ; Walker, Christopher ; Mitchell, Jerry ; Petrou, Mario ; De Robertis, Fabio ; Stock, Ulrich ; McGovern, Ian
Izvornik
Journal of Cardiac Surgery (0886-0440) 37
(2022), 4;
747-759
Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni
Ključne riječi
lung transplantation, extracorporeal membrane oxygenation, bridging
Sažetak
Objectives Venovenous extracorporeal membrane oxygenation (VV-ECMO) is increasingly being used in acutely deteriorating patients with end-stage lung disease as a bridge to transplantation (BTT). It can allow critically ill recipients to remain eligible for lung transplants (LTx) while reducing pretransplant deconditioning. We analyzed early- and midterm postoperative outcomes of patients on VV-ECMO as a BTT and the impact of preoperative VV-ECMO on posttransplant survival outcomes. Methods All consecutive LTx performed at our institution between January 2012 and December 2018 were analyzed. After matching, BTT patients were compared with nonbridged LTx recipients. Results Out of 297 transplanted patients, 21 (7.1%) were placed on VV-ECMO as a BTT. After matching, we observed similar 30-day mortality between BTT and non-BTT patients (4.6% vs. 6.6%, p = .083) despite a higher incidence of early postoperative complications (need for ECMO, delayed chest closure, and acute kidney injury). Furthermore, preoperative VV-ECMO did not appear associated with 30-day or 1-year mortality in both frequentist and Bayesian analysis (odds ratio [OR]: 0.35, 95% confidence interval: 0.03–3.49, p = .369 ; OR: 0.27, 95% credible interval: 0.01– 3.82, p = 84.7%, respectively). In sensitivity analysis, both subgroups were similar in respect to 30-day (7.8% vs. 6.5%, p = .048) and 1-year mortality (12.5% vs. 18%, p = .154). Conclusions Patients with acute refractory respiratory failure while waiting for LTx represent a high-risk cohort of patients. VV-ECMO as a BTT is a reasonable strategy in adult patients with acceptable operative mortality and 1-year survival comparable to non-BTT patients.
Izvorni jezik
Engleski
POVEZANOST RADA
Ustanove:
Medicinski fakultet, Zagreb
