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Review
. 2023 Feb;37(2):e14875.
doi: 10.1111/ctr.14875. Epub 2022 Dec 18.

State of the art - Extracorporeal membrane oxygenation as a bridge to thoracic transplantation

Erik Orozco-Hernandez  1 , Thomas Kurt DeLay  1 , Enrique Gongora  1 , Chris Bellot  1 , Victoria Rusanov  2 , Keith Wille  2 , Jose Tallaj  3 , Salpy Pamboukian  4 , Thomas Kaleekal  2 , Sam Mcelwee  3 , Charles Hoopes  1
Affiliations
Review

State of the art - Extracorporeal membrane oxygenation as a bridge to thoracic transplantation

Erik Orozco-Hernandez et al. Clin Transplant. 2023 Feb.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) has revolutionized the treatment of refractory cardiac and respiratory failure, and its use continues to increase, particularly in adults. However, ECMO-related morbidity and mortality remain high.

Main text: In this review, we investigate and expand upon the current state of the art in thoracic transplant and extracorporeal life support (ELS). In particular, we examine recent increase in incidence of heart transplant in patients supported by ECMO; the potential changes in patient care and selection for transplant in the years prior to updated United Network for Organ Sharing (UNOS) organ allocation guidelines versus those in the years following, particularly where these guidelines pertain to ECMO; and the newly revived practice of heart-lung block transplants (HLT) and the prevalence and utility of ECMO support in patients listed for HLT.

Conclusions: Our findings highlight encouraging outcomes in patients bridged to transplant with ECMO, considerable changes in treatment surrounding the updated UNOS guidelines, and complex, diverse outcomes among different centers in their care for increasingly ill patients listed for thoracic transplant.

Keywords: ECMO; bridge; heart; heart-lung; lung; thoracic transplant.

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References

REFERENCES

    1. Kwak J, Majewski MB, Jellish WS. Extracorporeal membrane oxygenation: the new Jack-of-all-trades? J Cardiothorac Vasc Anesth. 2020;34:192-207.
    1. Pasrija C, Mackowick KM, Raithel M, et al. Ambulation with femoral arterial cannulation can be safely performed on venoarterial extracorporeal membrane oxygenation. Ann Thorac Surg. 2019;107:1389-1394.
    1. Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373:1874-1882.
    1. Shudo Y, Kasinpila P, Lee AM, et al. Ambulating femoral venoarterial extracorporeal membrane oxygenation bridge to heart-lung transplant. J Thorac Cardiovasc Surg. 2018;156:e135.
    1. Orozco-Hernandez EJ, Melnikoff B, Lusby M, Tallaj J, Hoopes CW. Peripheral femoral venoarterial extracorporeal membrane oxygenation as bridge to heart-lung transplant omne iter incipit primus. J Card Surg. 2020;35:2077-2080. doi:10.1111/jocs.14779

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