Outcomes of Extracorporeal Membrane Oxygenation for Primary Graft Dysfunction After Lung Transplantation
Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Primary graft dysfunction (PGD) is the leading cause of death in the first 30 days after lung transplantation and is also associated with worse long-term outcomes. Outcomes of patients with PGD grade 3 requiring extracorporeal membrane oxygenation (ECMO) support after lung transplantation have yet to be well described. We sought to describe short- and long-term outcomes for patients with PGD grade 3 who required ECMO support.
METHODS: This is a single-center retrospective cohort study of patients undergoing lung transplantation. We stratified patients with PGD grade 3 into non-ECMO, venoarterial (VA) ECMO, and venovenous (VV) ECMO groups after transplantation. We then compared the outcomes between the groups.
RESULTS: Of 773 lung transplant recipients, PGD grade 3 developed in 204 (26%) at any time in the first 72 hours after lung transplantation. Of these, 13 (5%) required VA ECMO and 25 (10%) required VV ECMO support. The 30-day, 1-year, and 5-year survival in the VA ECMO group was 62%, 54%, and 43% compared with 96%, 84%, and 65% in the VV ECMO group and 99%, 94%, and 71% in the non-ECMO group. Multivariable Cox regression analysis showed that VA ECMO was associated with increased mortality (hazard ratio, 2.37; 95% CI, 1.06-5.28; P = .04).
CONCLUSIONS: Patients who required VA ECMO support for PGD grade 3 have significantly worse survival compared with those who did not require ECMO and those who required VV ECMO support. This suggests that VA ECMO treatment of patients with PGD grade 3 after lung transplantation can be a predictable risk factor for mortality.
| Errataetall: |
CommentIn: Ann Thorac Surg. 2023 May;115(5):1280-1281. - PMID 36746330 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:115 |
|---|---|
| Enthalten in: |
The Annals of thoracic surgery - 115(2023), 5 vom: 10. Mai, Seite 1273-1280 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Takahashi, Tsuyoshi [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 25.04.2023 Date Revised 02.05.2023 published: Print-Electronic CommentIn: Ann Thorac Surg. 2023 May;115(5):1280-1281. - PMID 36746330 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.athoracsur.2022.12.038 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM351457909 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM351457909 | ||
| 003 | DE-627 | ||
| 005 | 20231226051420.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.athoracsur.2022.12.038 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1171.xml |
| 035 | |a (DE-627)NLM351457909 | ||
| 035 | |a (NLM)36634836 | ||
| 035 | |a (PII)S0003-4975(23)00014-0 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Takahashi, Tsuyoshi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes of Extracorporeal Membrane Oxygenation for Primary Graft Dysfunction After Lung Transplantation |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 25.04.2023 | ||
| 500 | |a Date Revised 02.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Ann Thorac Surg. 2023 May;115(5):1280-1281. - PMID 36746330 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Primary graft dysfunction (PGD) is the leading cause of death in the first 30 days after lung transplantation and is also associated with worse long-term outcomes. Outcomes of patients with PGD grade 3 requiring extracorporeal membrane oxygenation (ECMO) support after lung transplantation have yet to be well described. We sought to describe short- and long-term outcomes for patients with PGD grade 3 who required ECMO support | ||
| 520 | |a METHODS: This is a single-center retrospective cohort study of patients undergoing lung transplantation. We stratified patients with PGD grade 3 into non-ECMO, venoarterial (VA) ECMO, and venovenous (VV) ECMO groups after transplantation. We then compared the outcomes between the groups | ||
| 520 | |a RESULTS: Of 773 lung transplant recipients, PGD grade 3 developed in 204 (26%) at any time in the first 72 hours after lung transplantation. Of these, 13 (5%) required VA ECMO and 25 (10%) required VV ECMO support. The 30-day, 1-year, and 5-year survival in the VA ECMO group was 62%, 54%, and 43% compared with 96%, 84%, and 65% in the VV ECMO group and 99%, 94%, and 71% in the non-ECMO group. Multivariable Cox regression analysis showed that VA ECMO was associated with increased mortality (hazard ratio, 2.37; 95% CI, 1.06-5.28; P = .04) | ||
| 520 | |a CONCLUSIONS: Patients who required VA ECMO support for PGD grade 3 have significantly worse survival compared with those who did not require ECMO and those who required VV ECMO support. This suggests that VA ECMO treatment of patients with PGD grade 3 after lung transplantation can be a predictable risk factor for mortality | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Terada, Yuriko |e verfasserin |4 aut | |
| 700 | 1 | |a Pasque, Michael K |e verfasserin |4 aut | |
| 700 | 1 | |a Nava, Ruben G |e verfasserin |4 aut | |
| 700 | 1 | |a Kozower, Benjamin D |e verfasserin |4 aut | |
| 700 | 1 | |a Meyers, Bryan F |e verfasserin |4 aut | |
| 700 | 1 | |a Patterson, G Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Kreisel, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Puri, Varun |e verfasserin |4 aut | |
| 700 | 1 | |a Hachem, Ramsey R |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Annals of thoracic surgery |d 1965 |g 115(2023), 5 vom: 10. Mai, Seite 1273-1280 |w (DE-627)NLM000026689 |x 1552-6259 |7 nnns |
| 773 | 1 | 8 | |g volume:115 |g year:2023 |g number:5 |g day:10 |g month:05 |g pages:1273-1280 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.athoracsur.2022.12.038 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 115 |j 2023 |e 5 |b 10 |c 05 |h 1273-1280 | ||