Outcome after extracorporeal membrane oxygenation-bridged lung retransplants: a single-centre experience.

Details

Serval ID
serval:BIB_64E1644063A4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Outcome after extracorporeal membrane oxygenation-bridged lung retransplants: a single-centre experience.
Journal
Interactive cardiovascular and thoracic surgery
Author(s)
Abdelnour-Berchtold E., Federici S., Wurlod D.A., Bellier J., Zellweger M., Kirsch M., Nicod L., Marcucci C., Baeriswyl M., Liaudet L., Soccal P.M., Gonzalez M., Perentes J.Y., Ris H.B., Krueger T., Aubert J.D.
ISSN
1569-9285 (Electronic)
ISSN-L
1569-9285
Publication state
Published
Issued date
01/06/2019
Peer-reviewed
Oui
Volume
28
Number
6
Pages
922-928
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
A lung retransplant has been shown to be a valid option in selected patients with chronic lung allograft dysfunction (CLAD). However, a subgroup of patients may require, in addition to invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO) as a bridge to a retransplant. Overall and CLAD-free survival after ECMO-bridged retransplants are compared to first transplants with and without bridging ECMO and to retransplants without bridging ECMO.
We reported a retrospective, single-institution experience based on a prospective data set of all patients undergoing lung transplants between January 2004 and December 2016 with a mean follow-up of 51 ± 41 months.
A total of 230 patients (96 men, 134 women, mean age 47.3 years) had lung transplants: 200 had first transplants without bridging ECMO; 13 had first transplants with bridging ECMO; 11 had retransplants without bridging ECMO; and 6 had retransplants with bridging ECMO. The 3- and 5-year survival rates were 81%/76%, 68%/68%, 69%/46% and 50%/25%, respectively. There was no significant difference in overall survival between those who had first transplants with and without bridging ECMO or retransplants without bridging ECMO. In contrast, patients undergoing ECMO-bridged retransplants had a significantly lower overall survival rate than those with a first transplant without bridging ECMO (P = 0.007). In addition, the post-transplant CLAD-free survival curves varied significantly among the 4 treatment groups (P = 0.041), paralleling overall survival.
Patients requiring ECMO as a bridge to a retransplant had lower overall and CLAD-free survival rates compared to those who had a first transplant with and without bridging ECMO and a retransplant without bridging ECMO.
Keywords
Adolescent, Adult, Aged, Child, Delayed Graft Function/mortality, Delayed Graft Function/surgery, Extracorporeal Membrane Oxygenation/methods, Female, Graft Survival, Humans, Lung Transplantation/methods, Lung Transplantation/mortality, Male, Middle Aged, Reoperation, Retrospective Studies, Survival Rate/trends, Switzerland/epidemiology, Treatment Outcome, Young Adult, Chronic allograft dysfunction, Lung transplantation, Retransplantation •Extracorporeal membrane oxygenation, Survival
Pubmed
Web of science
Open Access
Yes
Create date
13/02/2019 10:32
Last modification date
05/01/2020 7:18
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