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Outcomes of perioperative extracorporeal membrane oxygenation use in patients undergoing lung transplantation

Authors
 Joo Han Song  ;  Ji Eun Park  ;  Jin Gu Lee  ;  Chang Young Lee  ;  Kyung Sik Nam  ;  Jee Won Suh  ;  Anes Kim  ;  Seung Hyun Lee  ;  Hyun Chel Joo  ;  Young Nam Youn  ;  Song Yee Kim  ;  Moo Suk Park  ;  Hyo Chae Paik 
Citation
 Journal of Thoracic Disease, Vol.9(12) : 5075-5084, 2017 
Journal Title
 Journal of Thoracic Disease 
ISSN
 2072-1439 
Issue Date
2017
Keywords
Extracorporeal membrane oxygenation (ECMO) ; intraoperative ECMO ; lung transplantation (LTx)
Abstract
Background: The aim of this single-center study is to review the transplant outcomes of patients receiving lung transplantation (LTx) using intraoperative extracorporeal membrane oxygenation (ECMO) according to the perioperative use of ECMO. Methods: We retrospectively reviewed the transplant outcomes of 107 consecutive patients who underwent LTx using intraoperative ECMO between March 2013 and August 2016 at Severance Hospital of Yonsei University (Seoul, Korea). Results: Patients were divided into the following three groups according to the use of perioperative ECMO: only intraoperative ECMO (n=47) or extended post-operative ECMO but no bridging and no postoperative ECMO re-implantation (secondary ECMO; n=28) as Group A (n=75); bridging ECMO without secondary ECMO (n=14) as Group B; and secondary ECMO with (n=7) or without (n=11) bridging as Group C. Baseline demographics were comparable among the three groups. The mean duration of preoperative ECMO bridging was 16.4±15.6 (n=21). After a median of 17.7 months (range, 3.1-40.9 months) for survivors, the one year overall survival (OS) rates after LTx for the three groups were 76.3%±5.2% for Group A, 59.9%±14.3% for Group B, and 14.0%±9.0% for Group C (P<0.0001). The secondary ECMO (Group C) was established a mean of 7.9±5.3 days after LTx. The main cause of secondary ECMO was acute respiratory failure from pneumonia, and the main cause of death was infection-related events. Conclusions: Our data suggests that the use of perioperative ECMO, including its extended postoperative use during LTx, is feasible and has favorable outcomes. However, as shown by the poor survival outcome after secondary ECMO, the development of solid strategy to reduce the need for secondary ECMO implantation after LTx seems important.
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DOI
10.21037/jtd.2017.10.142
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
남경식(Narm, Kyoung Shik)
박무석(Park, Moo Suk) ORCID logo https://orcid.org/0000-0003-0820-7615
백효채(Paik, Hyo Chae) ORCID logo https://orcid.org/0000-0001-9309-8235
서지원(Suh, Jee Won)
송주한(Song, Joo Han)
윤영남(Youn, Young Nam)
이승현(Lee, Seung Hyun) ORCID logo https://orcid.org/0000-0002-0311-6565
이진구(Lee, Jin Gu)
이창영(Lee, Chang Young)
주현철(Joo, Hyun Chel) ORCID logo https://orcid.org/0000-0002-6842-2942
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165616
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