• Madeleine Otto, David McGiffin, Helen Whitford, Christina Kure, Gregory Snell, Arne Diehl, Judit Orosz, and BurrellAidan J CAJCDepartment of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, 55 Commercial Road, Melbourne, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash Univ.
• Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, 55 Commercial Road, Melbourne, Australia. Electronic address: M.Otto@alfred.org.au.
• J Crit Care. 2022 Dec 1; 72: 154120154120.

PurposeBilateral lung transplantation for end-stage pulmonary arterial hypertension (PAH) is traditionally associated with higher early post-transplant mortality when compared with other indications. Changes in perioperative management, including the growing use of perioperative extracorporeal membrane oxygenation (ECMO) and an increased awareness of postoperative left ventricular dysfunction (LVD), have resulted in outcomes that are uncertain.Materials And MethodsWe conducted a single-center, retrospective observational study at a lung transplantation center in Melbourne, Australia, from 2006 to 2019. ECMO use was categorized as preoperative, prophylactic, or rescue. Postoperative LVD was defined as a reduction in left ventricular function on echocardiography or using strict clinical criteria.Results50 patients underwent lung transplantation for PAH. 12-month survival was 48/50 (96%). ECMO was used in 26 (52%) patients, and the use of prophylactic VA-ECMO increased over the study period. Postoperative LVD was diagnosed in 21 (42%) patients. 12-month survival and left ventricular function was no different between LVD and non-LVD groups.ConclusionsThis study showed that high survival rates can be achieved following lung transplantation for PAH. We found that ECMO utilization was common, and indications have changed over time. LVD was common but did not impact 12-month survival.Copyright © 2022 Elsevier Inc. All rights reserved.

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