title: Growing experience with extracorporeal membrane oxygenation as a bridge to lung transplantation.
abstract: Extracorporeal membrane oxygenation (ECMO) is rarely used as a bridge to lung transplantation (BTT) because of its associated morbidity and mortality. However, recent advancements in perfusion technology and critical care have revived interest in this application of ECMO. We retrospectively reviewed our utilization of ECMO as BTT and evaluated our early and midterm results. Nineteen patients were placed on ECMO with the intent to transplant of which 14 (74%) were successfully transplanted. Early and midterm survival of transplanted patients was 75% (1 year) and 63% (3 years), respectively, with the most favorable results observed in interstitial lung disease patients supported in the venovenous configuration. Extracorporeal membrane oxygenation-bridged transplant survival rates were equivalent to nonbridged recipients, but early morbidity and mortality are high and the failure to bridge to transplant is significant. Overall, successfully bridged patients can derive a tangible benefit, albeit with considerable consumption of resources.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Shafii
authors.forename: David P
authors.initials: DP
authors.lastname: Mason
authors.forename: Chase R
authors.initials: CR
authors.lastname: Brown
authors.forename: Nakul
authors.initials: N
authors.lastname: Vakil
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Johnston
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: McCurry
authors.forename: Gosta B
authors.initials: GB
authors.lastname: Pettersson
authors.forename: Sudish C
authors.initials: SC
authors.lastname: Murthy
mesh_terms: D000328:Adult; D003550:Cystic Fibrosis / Q000401:mortality / Q000601:surgery / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000401:mortality / Q000601:surgery / Q000628:therapy; D054990:Idiopathic Pulmonary Fibrosis / Q000401:mortality / Q000601:surgery / Q000628:therapy; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000401:mortality / Q000601:surgery / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult