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Single-center experience with intraoperative extracorporeal membrane oxygenation use in lung transplantation

Abstract

Background

Studies have shown that survival after lung transplantation is impaired if extracorporeal membrane oxygenation (ECMO) support is implemented. We investigated the outcome and potential independent risk factors on survival in recipients undergoing lung transplantation with intraoperative ECMO support.

Materials and methods

Medical records of recipients were retrospectively evaluated (January 2000-December 2014). Retransplantation and bridge to transplantation on ECMO were excluded. Recipients (n = 291) were divided into 2 groups: those who needed intraoperative ECMO support (Group 1, n = 134) and those who did not receive intraoperative ECMO support (Group 2, n = 157). Independent risk factors were identified by a stepwise backward regression analysis.

Results

1-year survival was 84.2% in Group 1 vs. 90.4% in Group 2, and 5-year survival was 52.8% in Group 1 vs. 70.5% in Group 2 (p = 0.002). Multivariate analysis indicated that recipient age (p = 0.001), renal replacement therapy (p = 0.001) and intraoperative ECMO support (p = 0.03) were significant risk factors for overall survival. The rate of postoperative early surgical complications was comparable between the two groups (p = 0.09). The number of patients requiring renal replacement therapy and experiencing late pulmonary complications was significantly higher in Group 1 (p = 0.02).

Conclusions

Our data showed that lung transplantation with intraoperative ECMO support is associated with poor outcomes.

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/IJAO.5000645

Authors

Tugba Cosgun, Sandra Tomaszek, Isabelle Opitz, Markus Wilhelm, Macé M. Schuurmans, Walter Weder, Ilhan Inci

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: None.

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Authors

Affiliations

  • Department of Thoracic Surgery, Zurich University Hospital, Zurich - Switzerland
  • Department of Cardiovascular Surgery, Zurich University Hospital, Zurich - Switzerland
  • Division of Respiratory Medicine, Zurich University Hospital, Zurich - Switzerland

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