• Clinics · Jan 2020

    Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center.

    • Flávio Pola-Dos-Reis, Marcos Naoyuki Samano, Luis Gustavo Abdalla, Guilherme Vieira Soares de Carvalho, Lucas Matos Fernandes, Oswaldo Gomes-Júnior, Rafael Medeiros Carraro, Priscila Cilene Leon Bueno de Camargo, Ricardo Henrique Oliveira Braga Teixeira, José Eduardo Afonso-Júnior, and Paulo Manoel Pêgo-Fernandes.
    • Programa de Transplante Pulmonar, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR.
    • Clinics (Sao Paulo). 2020 Jan 1; 75: e1698.

    ObjectiveTo report initial experience from the use of extracorporeal membrane oxygenation (ECMO) in patients who received lung transplantation.MethodsRetrospective study of a single tertiary center in the Brazilian state of São Paulo, a national reference in lung transplantation, based on the prospective collection of data from electronic medical records. The period analyzed extended from January 2009 (beginning of the program) until December 2018.ResultsA total of 75 lung transplants were performed, with ECMO used in 8 (10.7%) cases. Of the patients, 4 (50%) were female. The mean age was 46.4±14.3 years. The causes of the end-stage lung disease that led to transplantation were pulmonary arterial hypertension in 3 (37.5%) patients, bronchiectasis in 2 (25%) patients, pulmonary fibrosis in 2 (25%) patients, and pulmonary emphysema in 1 (12.5%) patient. In our series, 7 (87.5%) cases were sequential bilateral transplantations. Prioritization was necessary in 4 (50%) patients, and in 1 patient, ECMO was used as a bridge to transplantation. The ECMO route was central in 4 (50%), peripheral venovenous in 2 (25%) and peripheral venoarterial in 2 (25%) patients. The mean length of the intensive care unit (ICU) stay was 14±7.5 days and of the hospital stay was 34.1±34.2 days. The mean ECMO duration was 9.3±6.6 days with a 50% decannulation rate. Three patients were discharged (37.5%).ConclusionLung transplantation requires complex treatment, and ECMO has allowed extending the indications for transplantation and provided adjuvant support in the clinical management of these patients.

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