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Transition to routine use of venoarterial extracorporeal oxygenation during lung transplantation could improve early outcomes

Authors
 Woo Sik Yu  ;  Hyo Chae Paik  ;  Seok Jin Haam  ;  Chang Young Lee  ;  Kyung Sik Nam  ;  Hee Suk Jung  ;  Young Woo Do  ;  Jee Won Shu  ;  Jin Gu Lee 
Citation
 JOURNAL OF THORACIC DISEASE, Vol.8(7) : 1712-1720, 2016 
Journal Title
 JOURNAL OF THORACIC DISEASE 
ISSN
 2072-1439 
Issue Date
2016
Keywords
Lung transplantation (LTx) ; extracorporeal life support (ECLS) ; venoarterial (VA)
Abstract
BACKGROUND: The study objective was to compare the outcomes of intraoperative routine use of venoarterial (VA) extracorporeal membrane oxygenation (ECMO) versus selective use of cardiopulmonary bypass (CPB). METHODS: Between January 2010 and February 2013, 41 lung transplantations (LTx) were performed, and CPB was used as a primary cardiopulmonary support modality by selective basis (group A). Between March 2013 and December 2014, 41 LTx were performed, and ECMO was used routinely (group B). The two groups were compared retrospectively. RESULTS: The operative time was significantly longer in group A (group A, 458 min; group B, 420 min; P=0.041). Postoperatively, patients in group B had less fresh frozen plasma (FFP) transfusion (P=0.030). Complications were not different between the two groups. The 30- and 90-day survival rates were better in group B (30-day survival: group A, 75.6%; group B, 95.1%, P=0.012; 90-day survival: group A, 68.3%; group B, 87.8%, P=0.033). The 1-year survival showed better trends in group B, but it was not significant. Forced vital capacity (FVC) at 1, 3, and 6 months after LTx was better in group B than in group A (1 month: group A, 43.8%; group B, 52.9%, P=0.043; 3 months: group A, 45.5%; group B, 59.0%, P=0.005; 6 months: group A, 51.5%; group B, 65.2%, P=0.020). Forced expiratory volume in 1 second (FEV1) at 3 months after LTx was better in patients in group B than that in patient in group A (group A, 53.3%; group B, 67.5%, P=0.017). CONCLUSIONS: Routine use of ECMO during LTx could improve early outcome and postoperative lung function without increased extracorporeal-related complication such as vascular and neurologic complications.
DOI
10.21037/jtd.2016.06.18
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Narm, Kyoung Shik(남경식)
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Suh, Jee Won(서지원) ORCID logo https://orcid.org/0000-0003-0287-0651
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151672
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