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DOI: 10.1055/s-0041-1728795
Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplant
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Abstract
Extracorporeal membrane oxygenation (ECMO) is a cardiopulmonary technology capable of supporting cardiac and respiratory function in the presence of end-stage lung disease. Initial experiences using ECMO as a bridge to lung transplant (ECMO-BTLT) were characterized by high rates of ECMO-associated complications and poor posttransplant outcomes. More recently, ECMO-BTLT has garnered success in preserving patients' physiologic condition and candidacy prior to lung transplant due to technological advances and improved management. Despite recent growth, clinical practice surrounding use of ECMO-BTLT remains variable, with little data to inform optimal patient selection and management. Although many questions remain, the use of ECMO-BTLT has shown promising outcomes suggesting that ECMO-BTLT can be an effective strategy to ensure that complex and rapidly decompensating patients with end-stage lung disease can be safely transplanted with good outcomes. Further studies are needed to refine and inform practice patterns, management, and lung allocation in this high-risk and fragile patient population.
Keywords
bridge to lung transplant - severe respiratory failure - end-stage lung disease - extracorporeal membrane oxygenation - extracorporeal life supportPublikationsverlauf
Artikel online veröffentlicht:
24. Mai 2021
© 2021. Thieme. All rights reserved.
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References
- 1 GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med 2020; 8 (06) 585-596
- 2 Valapour M, Lehr CJ, Skeans MA. et al. OPTN/SRTR 2018 Annual Data Report: lung. Am J Transplant 2020; 20 (Suppl s1): 427-508
- 3 George TJ, Beaty CA, Kilic A, Shah PD, Merlo CA, Shah AS. Outcomes and temporal trends among high-risk patients after lung transplantation in the United States. J Heart Lung Transplant 2012; 31 (11) 1182-1191
- 4 Hayanga AJ, Du AL, Joubert K. et al. Mechanical ventilation and extracorporeal membrane oxygenation as a bridging strategy to lung transplantation: significant gains in survival. Am J Transplant 2018; 18 (01) 125-135
- 5 O'Brien G, Criner GJ. Mechanical ventilation as a bridge to lung transplantation. J Heart Lung Transplant 1999; 18 (03) 255-265
- 6 Mason DP, Thuita L, Nowicki ER, Murthy SC, Pettersson GB, Blackstone EH. Should lung transplantation be performed for patients on mechanical respiratory support? The US experience. J Thorac Cardiovasc Surg 2010; 139 (03) 765-773.e1
- 7 Singer JP, Blanc PD, Hoopes C. et al. The impact of pretransplant mechanical ventilation on short- and long-term survival after lung transplantation. Am J Transplant 2011; 11 (10) 2197-2204
- 8 Tipograf Y, Salna M, Minko E. et al. Outcomes of extracorporeal membrane oxygenation as a bridge to lung transplantation. Ann Thorac Surg 2019; 107 (05) 1456-1463
- 9 Fuehner T, Kuehn C, Hadem J. et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. Am J Respir Crit Care Med 2012; 185 (07) 763-768
- 10 Hayanga JWA, Hayanga HK, Holmes SD. et al. Mechanical ventilation and extracorporeal membrane oxygenation as a bridge to lung transplantation: closing the gap. J Heart Lung Transplant 2019; 38 (10) 1104-1111
- 11 Strueber M. Bridges to lung transplantation. Curr Opin Organ Transplant 2011; 16 (05) 458-461
- 12 Valapour M, Skeans MA, Heubner BM. et al. OPTN/SRTR 2012 Annual Data Report: lung. Am J Transplant 2014; 14 (Suppl. 01) 139-165
- 13 Li SS, Miller R, Tumin D, Stewart WCL, Tobias JD, Hayes Jr D. Lung allocation score thresholds prioritize survival after lung transplantation. Chest 2019; 156 (01) 64-70
- 14 Lehr CJ, Zaas DW, Cheifetz IM, Turner DA. Ambulatory extracorporeal membrane oxygenation as a bridge to lung transplantation: walking while waiting. Chest 2015; 147 (05) 1213-1218
- 15 Garcia JP, Kon ZN, Evans C. et al. Ambulatory veno-venous extracorporeal membrane oxygenation: innovation and pitfalls. J Thorac Cardiovasc Surg 2011; 142 (04) 755-761
- 16 Gannon WD, Stokes JW, Bacchetta M. POINT: should patients with advanced lung disease be offered extracorporeal membrane oxygenation as a bridge to transplant if they have not yet been listed for lung transplant? Yes. Chest 2020; 158 (01) 35-38
- 17 Warren WA, Walter RJ, Mason PE. COUNTERPOINT: should patients with advanced lung disease be offered extracorporeal membrane oxygenation as a bridge to transplant if they have not yet been listed for lung transplant? No. Chest 2020; 158 (01) 38-40
- 18 Hakim AH, Ahmad U, McCurry KR. et al. Contemporary outcomes of extracorporeal membrane oxygenation used as bridge to lung transplantation. Ann Thorac Surg 2018; 106 (01) 192-198
- 19 Hoetzenecker K, Donahoe L, Yeung JC. et al. Extracorporeal life support as a bridge to lung transplantation-experience of a high-volume transplant center. J Thorac Cardiovasc Surg 2018; 155 (03) 1316-1328.e1
- 20 Chicotka S, Pedroso FE, Agerstrand CL. et al. Increasing opportunity for lung transplant in interstitial lung disease with pulmonary hypertension. Ann Thorac Surg 2018; 106 (06) 1812-1819
- 21 Habertheuer A, Richards T, Sertic F. et al. Stratification risk analysis in bridging patients to lung transplant on ECMO: the STABLE risk score. Ann Thorac Surg 2020; 110 (04) 1175-1184
- 22 Halpern AL, Kohtz PD, Helmkamp L. et al. Improved mortality associated with the use of extracorporeal membrane oxygenation. Ann Thorac Surg 2019; 108 (02) 350-357
- 23 Veith FJ, Koerner SK. The present status of lung transplantation. Arch Surg 1974; 109 (06) 734-740
- 24 Kayser KL. Blood-gas interface oxygenators versus membrane oxygenators: what are the proved differences?. Ann Thorac Surg 1974; 17 (05) 459-463
- 25 Hardy JD, Webb WR, Dalton Jr ML, Walker Jr GR. Lung homotransplantation in man. JAMA 1963; 186: 1065-1074
- 26 Nelems JM, Rebuck AS, Cooper JD, Goldberg M, Halloran PF, Vellend H. Human lung transplantation. Chest 1980; 78 (04) 569-573
- 27 Hill JD, O'Brien TG, Murray JJ. et al. Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Engl J Med 1972; 286 (12) 629-634
- 28 Veith FJ. Lung transplantation. Transplant Proc 1977; 9 (01) 203-208
- 29 Sequential bilateral lung transplantation for paraquat poisoning. A case report. The Toronto Lung Transplant group. J Thorac Cardiovasc Surg 1985; 89 (05) 734-742
- 30 Jurmann MJ, Haverich A, Demertzis S, Schaefers HJ, Wagner TO, Borst HG. Extracorporeal membrane oxygenation as a bridge to lung transplantation. Eur J Cardiothorac Surg 1991; 5 (02) 94-97 , discussion 98
- 31 Egan TM, Murray S, Bustami RT. et al. Development of the new lung allocation system in the United States. Am J Transplant 2006; 6 (5, Pt 2): 1212-1227
- 32 Toomasian JM, Schreiner RJ, Meyer DE. et al. A polymethylpentene fiber gas exchanger for long-term extracorporeal life support. ASAIO J 2005; 51 (04) 390-397
- 33 Egan TM, Edwards LB. Effect of the lung allocation score on lung transplantation in the United States. J Heart Lung Transplant 2016; 35 (04) 433-439
- 34 Fumeaux T, Rothmeier C, Jolliet P. Outcome of mechanical ventilation for acute respiratory failure in patients with pulmonary fibrosis. Intensive Care Med 2001; 27 (12) 1868-1874
- 35 Gannon WD, Lederer DJ, Biscotti M. et al. Outcomes and mortality prediction model of critically ill adults with acute respiratory failure and interstitial lung disease. Chest 2018; 153 (06) 1387-1395
- 36 Nosotti M, Rosso L, Tosi D. et al. Extracorporeal membrane oxygenation with spontaneous breathing as a bridge to lung transplantation. Interact Cardiovasc Thorac Surg 2013; 16 (01) 55-59
- 37 Nishinaka T, Tatsumi E, Katagiri N. et al. Up to 151 days of continuous animal perfusion with trivial heparin infusion by the application of a long-term durable antithrombogenic coating to a combination of a seal-less centrifugal pump and a diffusion membrane oxygenator. J Artif Organs 2007; 10 (04) 240-244
- 38 Brodie D, Slutsky AS, Combes A. Extracorporeal life support for adults with respiratory failure and related indications: a review. JAMA 2019; 322 (06) 557-568
- 39 Conrad SA, Broman LM, Taccone FS. et al. The Extracorporeal Life Support Organization Maastricht Treaty for Nomenclature in Extracorporeal Life Support. A position paper of the Extracorporeal Life Support Organization. Am J Respir Crit Care Med 2018; 198 (04) 447-451
- 40 Benazzo A, Schwarz S, Frommlet F. et al; Vienna ECLS Program. Twenty-year experience with extracorporeal life support as bridge to lung transplantation. J Thorac Cardiovasc Surg 2019; 157 (06) 2515-2525.e10
- 41 Haneya A, Philipp A, Mueller T. et al. Extracorporeal circulatory systems as a bridge to lung transplantation at remote transplant centers. Ann Thorac Surg 2011; 91 (01) 250-255
- 42 Keller SP. Contemporary approaches in the use of extracorporeal membrane oxygenation to support patients waiting for lung transplantation. Ann Cardiothorac Surg 2020; 9 (01) 29-41
- 43 Chiumello D, Coppola S, Froio S, Colombo A, Del Sorbo L. Extracorporeal life support as bridge to lung transplantation: a systematic review. Crit Care 2015; 19: 19
- 44 Biscotti M, Lee A, Basner RC. et al. Hybrid configurations via percutaneous access for extracorporeal membrane oxygenation: a single-center experience. ASAIO J 2014; 60 (06) 635-642
- 45 Abrams DC, Brodie D, Rosenzweig EB, Burkart KM, Agerstrand CL, Bacchetta MD. Upper-body extracorporeal membrane oxygenation as a strategy in decompensated pulmonary arterial hypertension. Pulm Circ 2013; 3 (02) 432-435
- 46 Biscotti M, Bacchetta M. The “sport model”: extracorporeal membrane oxygenation using the subclavian artery. Ann Thorac Surg 2014; 98 (04) 1487-1489
- 47 Chicotka S, Rosenzweig EB, Brodie D, Bacchetta M. The “central sport model”: extracorporeal membrane oxygenation using the innominate artery for smaller patients as bridge to lung transplantation. ASAIO J 2017; 63 (04) e39-e44
- 48 Nam KH, Koh Y, Lim CM. et al. Central extracorporeal membrane oxygenation for bridging of right-sided heart failure to lung transplantation: a single-center experience and literature review. J Cardiothorac Vasc Anesth 2019; 33 (07) 1873-1876
- 49 Tipograf Y, Gannon WD, Foley NM. et al. A dual-lumen bicaval cannula for venovenous extracorporeal membrane oxygenation. Ann Thorac Surg 2020; 109 (04) 1047-1053
- 50 Biscotti M, Sonett J, Bacchetta M. ECMO as bridge to lung transplant. Thorac Surg Clin 2015; 25 (01) 17-25
- 51 Ius F, Natanov R, Salman J. et al. Extracorporeal membrane oxygenation as a bridge to lung transplantation may not impact overall mortality risk after transplantation: results from a 7-year single-centre experience. Eur J Cardiothorac Surg 2018; 54 (02) 334-340
- 52 Anile M, Diso D, Russo E. et al. Extracorporeal membrane oxygenation as bridge to lung transplantation. Transplant Proc 2013; 45 (07) 2621-2623
- 53 Todd EM, Biswas Roy S, Hashimi AS. et al. Extracorporeal membrane oxygenation as a bridge to lung transplantation: a single-center experience in the present era. J Thorac Cardiovasc Surg 2017; 154 (05) 1798-1809
- 54 Biscotti M, Gannon WD, Agerstrand C. et al. Awake extracorporeal membrane oxygenation as bridge to lung transplantation: a 9-year experience. Ann Thorac Surg 2017; 104 (02) 412-419
- 55 Bermudez CA, Rocha RV, Zaldonis D. et al. Extracorporeal membrane oxygenation as a bridge to lung transplant: midterm outcomes. Ann Thorac Surg 2011; 92 (04) 1226-1231 , discussion 1231–1232
- 56 Hayes Jr D, Kukreja J, Tobias JD, Ballard HO, Hoopes CW. Ambulatory venovenous extracorporeal respiratory support as a bridge for cystic fibrosis patients to emergent lung transplantation. J Cyst Fibros 2012; 11 (01) 40-45
- 57 Hayanga AJ, Aboagye JK, Hayanga HE. et al. Contemporary analysis of early outcomes after lung transplantation in the elderly using a national registry. J Heart Lung Transplant 2015; 34 (02) 182-188
- 58 Hayes Jr D, Whitson BA, Black SM, Preston TJ, Papadimos TJ, Tobias JD. Influence of age on survival in adult patients on extracorporeal membrane oxygenation before lung transplantation. J Heart Lung Transplant 2015; 34 (06) 832-838
- 59 Crotti S, Iotti GA, Lissoni A. et al. Organ allocation waiting time during extracorporeal bridge to lung transplant affects outcomes. Chest 2013; 144 (03) 1018-1025
- 60 Sell JL, Bacchetta M, Goldfarb SB. et al. Short stature and access to lung transplantation in the United States. A cohort study. Am J Respir Crit Care Med 2016; 193 (06) 681-688
- 61 Kim M, Townsend KR, Wood IG. et al. Impact of pretransplant anti-HLA antibodies on outcomes in lung transplant candidates. Am J Respir Crit Care Med 2014; 189 (10) 1234-1239
- 62 Warren WA, Franco-Palacios D, King CS. et al. A 24-year-old woman with precipitous respiratory failure after lung transplantation. Chest 2018; 153 (03) e53-e56
- 63 Wordingham SE, McIlvennan CK. Palliative care for patients on mechanical circulatory support. AMA J Ethics 2019; 21 (05) E435-E442
- 64 Turner DA, Cheifetz IM, Rehder KJ. et al. Active rehabilitation and physical therapy during extracorporeal membrane oxygenation while awaiting lung transplantation: a practical approach. Crit Care Med 2011; 39 (12) 2593-2598
- 65 Abrams DC, Prager K, Blinderman CD, Burkart KM, Brodie D. Ethical dilemmas encountered with the use of extracorporeal membrane oxygenation in adults. Chest 2014; 145 (04) 876-882
- 66 Jaramillo C, Braus N. How should ECMO initiation and withdrawal decisions be shared?. AMA J Ethics 2019; 21 (05) E387-E393
- 67 Lederer DJ, Arcasoy SM, Wilt JS, D'Ovidio F, Sonett JR, Kawut SM. Six-minute-walk distance predicts waiting list survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2006; 174 (06) 659-664
- 68 Castleberry A, Mulvihill MS, Yerokun BA. et al. The utility of 6-minute walk distance in predicting waitlist mortality for lung transplant candidates. J Heart Lung Transplant 2017; 36 (07) 780-786
- 69 Singh SJ, Puhan MA, Andrianopoulos V. et al. An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J 2014; 44 (06) 1447-1478
- 70 Martinu T, Babyak MA, O'Connell CF. et al; INSPIRE Investigators. Baseline 6-min walk distance predicts survival in lung transplant candidates. Am J Transplant 2008; 8 (07) 1498-1505
- 71 Abdulai RM, Jensen TJ, Patel NR. et al. Deterioration of limb muscle function during acute exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2018; 197 (04) 433-449
- 72 Rosenzweig EB, Gannon WD, Madahar P. et al. Extracorporeal life support bridge for pulmonary hypertension: a high-volume single-center experience. J Heart Lung Transplant 2019; 38 (12) 1275-1285
- 73 Rosenzweig EB, Brodie D, Abrams DC, Agerstrand CL, Bacchetta M. Extracorporeal membrane oxygenation as a novel bridging strategy for acute right heart failure in group 1 pulmonary arterial hypertension. ASAIO J 2014; 60 (01) 129-133
- 74 Olsson KM, Simon A, Strueber M. et al. Extracorporeal membrane oxygenation in nonintubated patients as bridge to lung transplantation. Am J Transplant 2010; 10 (09) 2173-2178
- 75 Diamond JM, Lee JC, Kawut SM. et al; Lung Transplant Outcomes Group. Clinical risk factors for primary graft dysfunction after lung transplantation. Am J Respir Crit Care Med 2013; 187 (05) 527-534
- 76 Porteous MK, Lee JC, Lederer DJ. et al; Lung Transplant Outcomes Group. Clinical risk factors and prognostic model for primary graft dysfunction after lung transplantation in patients with pulmonary hypertension. Ann Am Thorac Soc 2017; 14 (10) 1514-1522
- 77 Tudorache I, Sommer W, Kühn C. et al. Lung transplantation for severe pulmonary hypertension--awake extracorporeal membrane oxygenation for postoperative left ventricular remodelling. Transplantation 2015; 99 (02) 451-458
- 78 Porteous MK, Ky B, Kirkpatrick JN. et al. Diastolic dysfunction increases the risk of primary graft dysfunction after lung transplant. Am J Respir Crit Care Med 2016; 193 (12) 1392-1400
- 79 Abrams DC, Brenner K, Burkart KM. et al. Pilot study of extracorporeal carbon dioxide removal to facilitate extubation and ambulation in exacerbations of chronic obstructive pulmonary disease. Ann Am Thorac Soc 2013; 10 (04) 307-314
- 80 Combes A, Auzinger G, Capellier G. et al. ECCO2R therapy in the ICU: consensus of a European round table meeting. Crit Care 2020; 24 (01) 490
- 81 Gross-Hardt S, Hesselmann F, Arens J. et al. Low-flow assessment of current ECMO/ECCO2R rotary blood pumps and the potential effect on hemocompatibility. Crit Care 2019; 23 (01) 348
- 82 Weig T, Irlbeck M, Frey L. et al. Parameters associated with short- and midterm survival in bridging to lung transplantation with extracorporeal membrane oxygenation. Clin Transplant 2013; 27 (05) E563-E570
- 83 Toyoda Y, Bhama JK, Shigemura N. et al. Efficacy of extracorporeal membrane oxygenation as a bridge to lung transplantation. J Thorac Cardiovasc Surg 2013; 145 (04) 1065-1071
- 84 Banga A, Mohanka M, Mullins J. et al. Incidence and variables associated with 30-day mortality after lung transplantation. Clin Transplant 2019; 33 (02) e13468
- 85 Russo MJ, Davies RR, Hong KN. et al. Who is the high-risk recipient? Predicting mortality after lung transplantation using pretransplant risk factors. J Thorac Cardiovasc Surg 2009; 138 (05) 1234-1238.e1
- 86 Crawford TC, Grimm JC, Magruder JT. et al. Lung transplant mortality is improving in recipients with a lung allocation score in the upper quartile. Ann Thorac Surg 2017; 103 (05) 1607-1613
- 87 Hayes Jr D, Tobias JD, Tumin D. Center volume and extracorporeal membrane oxygenation support at lung transplantation in the Lung Allocation Score Era. Am J Respir Crit Care Med 2016; 194 (03) 317-326
- 88 Egan TM, Kotloff RM. Pro/Con debate: lung allocation should be based on medical urgency and transplant survival and not on waiting time. Chest 2005; 128 (01) 407-415
- 89 Organ Procurement and Transplantation Network. Organ Procurement and Transplantation Network. Health Resources and Services Administration, HHS. Final rule. Fed Regist 1999; 64 (202) 56650-56661
- 90 Van Raemdonck D, Keshavjee S, Levvey B. et al; International Society for Heart and Lung Transplantation. Donation after circulatory death in lung transplantation-five-year follow-up from ISHLT Registry. J Heart Lung Transplant 2019; 38 (12) 1235-1245
- 91 Christie IG, Chan EG, Ryan JP. et al. National trends in extended criteria donor utilization and outcomes for lung transplantation. Ann Thorac Surg 2020
- 92 Divithotawela C, Cypel M, Martinu T. et al. Long-term outcomes of lung transplant with ex vivo lung perfusion. JAMA Surg 2019; 154 (12) 1143-1150
- 93 Martens A, Van Raemdonck DE, Smits J. et al. A retrospective database analysis to evaluate the potential of ex vivo lung perfusion to recruit declined lung donors. Transpl Int 2017; 30 (10) 1002-1010
- 94 Naito N, Cook K, Toyoda Y, Shigemura N. Artificial lungs for lung failure: JACC Technology Corner. J Am Coll Cardiol 2018; 72 (14) 1640-1652
- 95 Rose EA, Gelijns AC, Moskowitz AJ. et al; Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med 2001; 345 (20) 1435-1443
- 96 Briasoulis A, Inampudi C, Akintoye E, Adegbala O, Alvarez P, Bhama J. Trends in utilization, mortality, major complications, and cost after left ventricular assist device implantation in the United States (2009 to 2014). Am J Cardiol 2018; 121 (10) 1214-1218
- 97 Skoog DJ, Pohlmann JR, Demos DS. et al. Fourteen day in vivo testing of a compliant thoracic artificial lung. ASAIO J 2017; 63 (05) 644-649
- 98 Madhani SP, Frankowski BJ, Burgreen GW. et al. In vitro and in vivo evaluation of a novel integrated wearable artificial lung. J Heart Lung Transplant 2017; 36 (07) 806-811