Lung transplantation following 107 days of extracorporeal membrane oxygenation

Abstract Severe adult respiratory distress syndrome (ARDS) is associated with failure to maintain adequate gas exchange. There is increasing success using extracorporeal membrane oxygenation (ECMO) for respiratory failure; the longest reported surviving patient has been supported by ECMO for 57 days...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2010-04, Vol.37 (4), p.969-971
Main Authors: Iacono, Aldo, Groves, Soleyah, Garcia, Jose, Griffith, Bartley
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiology. Vascular system
Extracorporeal Membrane Oxygenation
Fatal Outcome
Humans
Lung Transplantation
Male
Medical sciences
Pneumology
Respiratory Distress Syndrome, Adult - therapy
Respiratory Insufficiency - surgery
Respiratory system : syndromes and miscellaneous diseases
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Young Adult
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Summary:Abstract Severe adult respiratory distress syndrome (ARDS) is associated with failure to maintain adequate gas exchange. There is increasing success using extracorporeal membrane oxygenation (ECMO) for respiratory failure; the longest reported surviving patient has been supported by ECMO for 57 days. At best about 50% wean from ECMO and should weaning fail their course is fatal. ECMO is generally considered to be a contraindication for successful lung transplantation. This report describes a patient maintained on ECMO for 107 days who underwent bilateral lung transplantation and weaned from organ-perfusion support. He survived for 351 days post-transplantation and died from Pseudomonas aeruginosa pneumonia. ECMO can be used for prolonged intervals to support patients with severe ARDS without complications that preclude lung transplantation. As ECMO use becomes more frequent, it becomes critical to determine criteria that would optimise patient selection for transplantation from ECMO.
ISSN:1010-7940
1873-734X
DOI:10.1016/j.ejcts.2009.09.039