Increasing Opportunity for Lung Transplant in Interstitial Lung Disease With Pulmonary Hypertension

The Annals of Thoracic Surgery
Scott ChicotkaMatthew Bacchetta

Abstract

Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation for end-stage interstitial lung disease (ILD) and pulmonary hypertension (PH) has varying results based on ECMO configuration. We compare our experience using venovenous (VV) and venoarterial (VA) ECMO bridge to transplantation for ILD with PH on survival to successful transplantation. A single-center retrospective review was done of patients with ILD and secondary PH who were placed on either VV or VA ECMO as bridge to transplantation from 2010 to 2016. Comparisons for factors associated with survival to transplantation between VV and VA ECMO strategies were made using Cox proportional hazards model. Subgroup analysis included comparisons of VV ECMO patients who remained on VV or were converted to VA ECMO. A total of 50 patients with ILD and PH were treated initially with either VV (n = 19) or VA (n = 31) ECMO as bridge to lung transplantation. Initial VA ECMO had a significantly higher survival to transplantation compared with initial VV ECMO (p = 0.03). Cox proportional hazards modeling showed a 59% reduction in risk of death for VA compared with VV ECMO (hazard reduction 0.41, 95% confidence interval: 0.18 to 0.92, p = 0.03). Patients converted f...Continue Reading

Citations

Aug 14, 2019·JAMA : the Journal of the American Medical Association·Daniel BrodieAlain Combes
Jul 24, 2020·Current Opinion in Pulmonary Medicine·Laurens J De SadeleerGeert M Verleden
Oct 25, 2020·Artificial Organs·Justyna SwolRoberto Lorusso
Apr 10, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Reda E Girgis, Marius M Hoeper
May 25, 2021·Seminars in Respiratory and Critical Care Medicine·John W StokesMatthew Bacchetta
Aug 19, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Christian A BermudezOlaf Mercier
Jan 10, 2022·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Martin BalikRobert Lischke

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