Blog
About

25
views
1
recommends
+1 Recommend
0
shares
  • Review: found
Is Open Access

Review of 'Lessons learned from extracorporeal membrane oxygenation as a bridge to lung transplantation'

Bookmark
4
solid review of the subject.
Average rating:
    Rated 4 of 5.
Level of importance:
    Rated 4 of 5.
Level of validity:
    Rated 4 of 5.
Level of completeness:
    Rated 4 of 5.
Level of comprehensibility:
    Rated 4 of 5.
Competing interests:
None

Reviewed article

  • Record: found
  • Abstract: found
  • Article: found
Is Open Access

Lessons learned from extracorporeal membrane oxygenation as a bridge to lung transplantation

 Vladimir Shumaster (corresponding) ,  Oliver Jawitz,  David Yuh (2014)
Extracorporeal membrane oxygenation (ECMO) has been used infrequently as a bridge to lung transplantation due to lack of consensus and data regarding the benefits of such a strategy. We present data from the United Network of Organ Sharing (UNOS) database on the outcomes of patients bridged to lung transplantation with ECMO. We used the UNOS database to analyze data between January 1, 2000 and December 31, 2011. During this time 14,263 lung transplants were performed, of which 143 (1.0%) were bridged using ECMO. Patients on ECMO as a bridge to lung transplantation were compared to those transplanted without prior ECMO support. Demographics, survival rates, complications, and rejection episodes were compared between the two groups. The 30-day, 6-month, 1-year, 3-year, and 5-year survival rates were 69%, 56%, 48%, 26%, and 11%, respectively, for the ECMO bridge group and 95%, 88%, 81%, 58%, and 38% respectively, for the control group (p ≤ 0.01). The ECMO group incurred higher rate of postoperative complications, including airway dehiscence (4% vs. 1%, p ≤ 0.01), stroke (3% vs. 2%, p ≤ 0.01), infection (56% vs. 42%, p ≤ 0.01), and pulmonary embolism (10% vs. 0.6%, p ≤ 0.01). The length of hospital stay was longer for the ECMO group (41 vs. 25 days, p ≤ 0.01), and they were treated for rejection more often (49% vs. 36%, p = 0.02). The use of ECMO as a bridge to lung transplantation is associated with significantly worse survival and more frequent postoperative complications. Therefore, we advocate very careful patient selection and cautious use of ECMO.
    Bookmark

    Review information

    10.14293/S2199-1006.1.SOR-MED.ABG1R6.v1.RLIRWF

    This work has been published open access under Creative Commons Attribution License CC BY 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com.

    ScienceOpen disciplines:
    Keywords:

    Review text

    Nicely written however, the authors need to explore the effects of center volume and time on outcomes. As documented in ref 7, results with ECMO as a bridging strategy have improved with time. So the authors can examine 2001-2005 vs 2010 and 2011 with 3 year outcomes available.

    Comments

    Comment on this review