title: Transition to routine use of venoarterial extracorporeal oxygenation during lung transplantation could improve early outcomes.
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.
authors: Department of Thoracic Surgery, Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, Korea;; Department of Medicine, The Graduate School of Yonsei University, Seoul, Korea;
authors: Woo Sik
authors: WS
authors: Yu
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yonsei University, Seoul, Korea ;
authors: Hyo Chae
authors: HC
authors: Paik
authors: Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Korea.
authors: Seok Jin
authors: SJ
authors: Haam
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yonsei University, Seoul, Korea ;
authors: Chang Young
authors: CY
authors: Lee
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yonsei University, Seoul, Korea ;
authors: Kyung Sik
authors: KS
authors: Nam
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yonsei University, Seoul, Korea ;
authors: Hee Suk
authors: HS
authors: Jung
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yonsei University, Seoul, Korea ;
authors: Young Woo
authors: YW
authors: Do
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yonsei University, Seoul, Korea ;
authors: Jee Won
authors: JW
authors: Shu
authors: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yonsei University, Seoul, Korea ;
authors: Jin Gu
authors: JG
authors: Lee
keywords: Lung transplantation (LTx); extracorporeal life support (ECLS); venoarterial (VA)