title: Extracorporeal membrane oxygenation as bridge to lung transplantation.
abstract: Lung transplantation (OLT) is a viable option for end-stage pulmonary diseases in selected patients with satisfactory long-term results. However, the paucity of available donors engenders a prolonged stay on the waiting list with progressive decline of lung function. In cases of sudden respiratory failure, admission to an intensive care unit with institution of extracorporeal membrane oxygenation (ECMO) may be an option while a waiting an emergency OLT. In 12 OLT candidates we started ECMO because of acute decline of lung function. Eleven patients had cystic fibrosis and the other subject, histiocytosis X. In 7 patients bilateral OLT was performed after a mean waiting time of 6 days from ECMO institution; 5 patients died on ECMO at a mean time of 11.6 days. After OLT 2 patients required reoperation for hemothorax; renal failure and acute leg ischemia occurred in 2 patients. The mean weaning time from ECMO after OLT was 2.14 days. No patient died in the perioperative period and 1-year survival was 85.7%. ECMO represents a valid option as a bridge to urgent OLT for selected candidates.
authors.affiliation: Department of Thoracic Surgery, University of Rome, Sapienza, Italy. Electronic address: marco.anile@uniromal.it.
authors.forename: M
authors.initials: M
authors.lastname: Anile
authors.forename: D
authors.initials: D
authors.lastname: Diso
authors.forename: E
authors.initials: E
authors.lastname: Russo
authors.forename: M
authors.initials: M
authors.lastname: Patella
authors.forename: C
authors.initials: C
authors.lastname: Carillo
authors.forename: Y
authors.initials: Y
authors.lastname: Pecoraro
authors.forename: I
authors.initials: I
authors.lastname: Onorati
authors.forename: F
authors.initials: F
authors.lastname: Pugliese
authors.forename: F
authors.initials: F
authors.lastname: Ruberto
authors.forename: T
authors.initials: T
authors.lastname: De Giacomo
authors.forename: D
authors.initials: D
authors.lastname: Angioletti
authors.forename: S
authors.initials: S
authors.lastname: Mantovani
authors.forename: G
authors.initials: G
authors.lastname: Mazzesi
authors.forename: G
authors.initials: G
authors.lastname: Frati
authors.forename: E A
authors.initials: EA
authors.lastname: Rendina
authors.forename: F
authors.initials: F
authors.lastname: Venuta
mesh_terms: D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D016040:Lung Transplantation