Haneya, Assad and Philipp, Alois and Mueller, Thomas and Lubnow, Matthias and Pfeifer, Michael and Zink, Wolfgang and Hilker, Michael and Schmid, Christof and Hirt, Stephan (2011) Extracorporeal Circulatory Systems as a Bridge to Lung Transplantation at Remote Transplant Centers. ANNALS OF THORACIC SURGERY, 91 (1). pp. 250-256. ISSN 0003-4975,
Full text not available from this repository. (Request a copy)Abstract
Background. Worsening of lung function in patients awaiting lung transplantation can lead to ventilation-refractory hypoxemia or hypercapnia and respiratory acidosis. This report describes the successful use of different extracorporeal circulatory systems as a bridge to transplantation at remote centers. Methods. Between January 2003 and December 2009, we had 10 requests for implantation of extracorporeal circulatory systems (pumpless extracorporeal lung assist [PECLA] or extracorporeal membrane oxygenation [ECMO]) in patients decompensating on the waiting list to bridge to transplantation at three different transplant centers between 150 km and 570 km apart. Cannulas were inserted percutaneously with Seldinger's technique. Results. The median patient age was 36 years (range, 24 to 53). Three patients were supported with PECLA and 7 with ECMO. The median duration of support was 23 days (range, 5 to 73). Two patients were initially provided with ECMO and then changed to PECLA after hemodynamic stabilization in the face of persisting pulmonary failure. Two patients died of multiorgan failure on ECMO while on the waiting list. One PECLA patient was successfully weaned and waiting for LTx. Before transplantation, 5 patients (4 PECLA and 1 ECMO) were successfully weaned from mechanical ventilation, and 3 PECLA patients were successfully weaned from the system. Seven patients were successfully bridged and transplanted. Five of 7 patients were discharged from the transplant centers. Conclusions. This report suggests that implantation of extracorporeal circulatory systems is a safe method to bridge patients decompensating on the waiting list for transplantation. Support intervals of several weeks are possible. (Ann Thorac Surg 2011; 91: 250-6) (C) 2011 by The Society of Thoracic Surgeons
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RESPIRATORY-DISTRESS-SYNDROME; ARTERIOVENOUS CO2 REMOVAL; MEMBRANE-OXYGENATION; INTERNATIONAL-SOCIETY; ASSIST; EXPERIENCE; FAILURE; LIFE; EUROTRANSPLANT; VENTILATION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Jun 2020 12:03 |
| Last Modified: | 29 Jun 2020 12:03 |
| URI: | https://pred.uni-regensburg.de/id/eprint/21484 |
Actions (login required)
 |
View Item |
