PMID- 35060184
OWN - NLM
STAT- MEDLINE
DCOM- 20220303
LR  - 20220303
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 37
IP  - 4
DP  - 2022 Apr
TI  - Midterm outcomes of venovenous extracorporeal membrane oxygenation as a bridge to 
      lung transplantation: Comparison with nonbridged recipients.
PG  - 747-759
LID - 10.1111/jocs.16253 [doi]
AB  - OBJECTIVES: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is 
      increasingly being used in acutely deteriorating patients with end-stage lung 
      disease as a bridge to transplantation (BTT). It can allow critically ill 
      recipients to remain eligible for lung transplants (LTx) while reducing 
      pretransplant deconditioning. We analyzed early- and midterm postoperative 
      outcomes of patients on VV-ECMO as a BTT and the impact of preoperative VV-ECMO 
      on posttransplant survival outcomes. METHODS: All consecutive LTx performed at 
      our institution between January 2012 and December 2018 were analyzed. After 
      matching, BTT patients were compared with nonbridged LTx recipients. RESULTS: Out 
      of 297 transplanted patients, 21 (7.1%) were placed on VV-ECMO as a BTT. After 
      matching, we observed similar 30-day mortality between BTT and non-BTT patients 
      (4.6% vs. 6.6%, p = .083) despite a higher incidence of early postoperative 
      complications (need for ECMO, delayed chest closure, and acute kidney injury). 
      Furthermore, preoperative VV-ECMO did not appear associated with 30-day or 1-year 
      mortality in both frequentist and Bayesian analysis (odds ratio [OR]: 0.35, 95% 
      confidence interval: 0.03-3.49, p = .369; OR: 0.27, 95% credible interval: 
      0.01-3.82, p = 84.7%, respectively). In sensitivity analysis, both subgroups were 
      similar in respect to 30-day (7.8% vs. 6.5%, p = .048) and 1-year mortality 
      (12.5% vs. 18%, p = .154). CONCLUSIONS: Patients with acute refractory 
      respiratory failure while waiting for LTx represent a high-risk cohort of 
      patients. VV-ECMO as a BTT is a reasonable strategy in adult patients with 
      acceptable operative mortality and 1-year survival comparable to non-BTT 
      patients.
CI  - (c) 2022 Wiley Periodicals LLC.
FAU - Sef, Davorin
AU  - Sef D
AUID- ORCID: 0000-0001-5053-3815
AD  - Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, 
      Royal Brompton & Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation 
      Trust, Harefield Hospital, London, UK.
FAU - Verzelloni Sef, Alessandra
AU  - Verzelloni Sef A
AUID- ORCID: 0000-0002-5049-7559
AD  - Department of Anesthesia and Critical Care, Royal Brompton & Harefield Hospitals, 
      Part of Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital, London, 
      UK.
FAU - Trkulja, Vladimir
AU  - Trkulja V
AUID- ORCID: 0000-0001-8045-5846
AD  - Department of Pharmacology, Zagreb University School of Medicine, Zagreb, 
      Croatia.
FAU - Raj, Binu
AU  - Raj B
AD  - Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, 
      Royal Brompton & Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation 
      Trust, Harefield Hospital, London, UK.
FAU - Lees, Nicholas J
AU  - Lees NJ
AD  - Department of Anesthesia and Critical Care, Royal Brompton & Harefield Hospitals, 
      Part of Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital, London, 
      UK.
FAU - Walker, Christopher
AU  - Walker C
AD  - Department of Anesthesia and Critical Care, Royal Brompton & Harefield Hospitals, 
      Part of Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital, London, 
      UK.
FAU - Mitchell, Jerry
AU  - Mitchell J
AD  - Department of Anesthesia and Critical Care, Royal Brompton & Harefield Hospitals, 
      Part of Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital, London, 
      UK.
FAU - Petrou, Mario
AU  - Petrou M
AD  - Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, 
      Royal Brompton & Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation 
      Trust, Harefield Hospital, London, UK.
FAU - De Robertis, Fabio
AU  - De Robertis F
AD  - Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, 
      Royal Brompton & Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation 
      Trust, Harefield Hospital, London, UK.
FAU - Stock, Ulrich
AU  - Stock U
AUID- ORCID: 0000-0002-2497-258X
AD  - Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, 
      Royal Brompton & Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation 
      Trust, Harefield Hospital, London, UK.
FAU - McGovern, Ian
AU  - McGovern I
AD  - Department of Anesthesia and Critical Care, Royal Brompton & Harefield Hospitals, 
      Part of Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital, London, 
      UK.
LA  - eng
PT  - Journal Article
DEP - 20220120
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Bayes Theorem
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Humans
MH  - *Lung Transplantation/methods
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - bridge to transplantation
OT  - extracorporeal membrane oxygenation
OT  - lung transplantation
OT  - matched analysis
OT  - venovenous
EDAT- 2022/01/22 06:00
MHDA- 2022/03/04 06:00
CRDT- 2022/01/21 06:45
PHST- 2021/11/28 00:00 [revised]
PHST- 2021/10/10 00:00 [received]
PHST- 2021/12/24 00:00 [accepted]
PHST- 2022/01/22 06:00 [pubmed]
PHST- 2022/03/04 06:00 [medline]
PHST- 2022/01/21 06:45 [entrez]
AID - 10.1111/jocs.16253 [doi]
PST - ppublish
SO  - J Card Surg. 2022 Apr;37(4):747-759. doi: 10.1111/jocs.16253. Epub 2022 Jan 20.