• Marion Lafarge, Pierre Mordant, Gabriel Thabut, Laurent Brouchet, Pierre-Emmanuel Falcoz, Alain Haloun, Françoise Le Pimpec-Barthes, Jean-Michel Maury, Martine Reynaud-Gaubert, Christelle Saint-Raymond, Edouard Sage, Marc Stern, Pascal Thomas, Yves Castier, Richard Dorent, and Hervé Mal.
• Department of Pneumology and Lung Transplantation, Hôpital Bichat, Paris, INSERM U 700, Université Paris Diderot-Paris.
• J. Heart Lung Transplant. 2013 Sep 1;32(9):905-13.

BackgroundExtracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation (LTx). However, data concerning this approach remain limited.MethodsWe retrospectively reviewed the medical records of all patients in France who received ECMO as a bridge to LTx from 2007 to 2011. Post-transplant survival and associated factors were assessed by the Kaplan-Meier method and the Cox model.ResultsIncluded were 36 patients from 11 centers. Indications for LTx were cystic fibrosis (CF) in 20 (56%), pulmonary fibrosis (PF) in 11 (30%), and other diagnoses in 5 (14%). ECMO was venovenous for 27 patients (75%) and venoarterial for 9 (25%). Mean follow-up was 17 months. Bridging to LTx was achieved in 30 patients (83%); however, only 27 patients (75%) survived the LTx procedure, and 20 (56%) were discharged from hospital. From ECMO initiation, 2-year survival rates were 50.4% overall, 71.0% for CF patients, 27.3% for PF patients, and 20.0% for other patients (p < 0.001). From LTx, 2-year survival rates were 60.5% overall, 71.0% for CF patients, 42.9% for PF patients, and 33.0% for other patients (p = 0.04).ConclusionsOur study confirms that the use of ECMO as a bridge to LTx in France could provide a medium-term survival benefit for LTx recipients with critical conditions. Survival differed by underlying respiratory disease. Larger studies are needed to further define the optimal use of ECMO.Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

32 keywords...

hide…