Source: Annual Congress 2012 - Lung transplantation: studies in candidates and recipients
Disease area: Interstitial lung diseases, Respiratory critical care

Abstract

Purpose: Death on the waiting list remains high in patients awaiting LTx. ECLS as a bridge may increase patient‘s survival. We present our initial experience.
Materials and Methods: Between Feb. 2010 and Dec. 2011 100 patients underwent LTx at our institution. 7 (7%) recipients were supported with ECLS prior to LTx. Outcome, donor and recipient parameters were analysed.
Results: Donor age was 21(20;47) (median (interquartile range)) y.; gender – F/M: 5/2, cause of death: intracranial haemorrhage 3, hypoxic brain injury 2, bacterial meningitis 2; duration of donor mechanical ventilation was 2(2;2.5) days; PaO₂/FiO₂ ratio: 63.4(58.15;69.45) kPa. One patient died during the support.

Table 1. Recipients‘ demographics and perioperative data.

RECIPIENT	1	2	3	4	5	6	7
AGE (years)	25	46	21	23	40	29	50
GENDER	M	F	F	F	F	F	M
DIAGNOSIS	CF	HP	CF	CF	PH	E-D	PF
TYPE OF ECLS	v-v ECMO	ILA	v-v ECMO	ILA/v-v ECMO	v-a ECMO	v-v ECMO	v-v ECMO
DURATION OF ECLS (days)	8	1	6	7/8	33	7	9
DURATION OF POSTOPERATIVE MV (hours)	624	384	72	46	304	398	301
ICU LOS (days)	26	26	10	11	18	19	17
HOSPITAL LOS (days)	70	45	30	41	169#	48	69
FEV1/FVC (%predicted) current	73.6/78.5	79.1/101	85.1/95	59.1/62.2	55.3/70.2	69.6/62	49.3/47
FOLLOW UP	739	416	221	182	169	86	67

CF-cystic fibrosis, HP – hypersensivity pneumonitis, PH – pulmonary hypertension, PF – pulmonary fibrosis, E-D – Elerhs-Danlos syndrome related emphysema, ECMO – Extracorporeal Mebrane Oxygenation, ILA – Interventional Lung Assist, LOS – lenht of stay . # Still in hospital.

Conclusion: ECLS as a bridge to LTx is a feasible option of treatment providing good early results. Longer weaning from mechanical ventilation, hospital and ICU LOS after transplantation should be expected.

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Citations should be made in the following way:
A. Reed, B. Zych, T. Bahrami, M. Amrani, P. Mohite, A. Moza, H. Krueger, M. Carby, A. Simon (Harefield, United Kingdom). Extracorporeal life support (ECLS) as a bridge to lung transplantation (LTx). Eur Respir J 2012; 40: Suppl. 56, 1483

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