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Bridge to lung transplantation and rescue post-transplant: the expanding role of extracorporeal membrane oxygenation.

Publication ,  Journal Article
Gulack, BC; Hirji, SA; Hartwig, MG
Published in: J Thorac Dis
August 2014

Over the last several decades, the growth of lung transplantation has been hindered by a much higher demand for donor lungs than can be supplied, leading to considerable waiting time and mortality among patients waiting for transplant. This has led to the search for an alternative bridging strategy in patients with end-stage lung disease. The use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation as well as a rescue strategy post-transplant for primary graft dysfunction (PGD) has been studied previously, however due to initially poor outcomes, its use was not heavily instituted. In recent years, with significant improvement in technologies, several single and multi-center studies have shown promising outcomes related to the use of ECMO as a bridging strategy as well as a therapy for patients suffering from PGD post-transplant. These results have challenged our current notion on ECMO use and hence forced us to reexamine the utility, efficacy and safety of ECMO in conjunction with lung transplantation. Through this review, we will address the various aspects related to ECMO use as a bridge to lung transplantation as well as a rescue post-transplant in the treatment of PGD. We will emphasize newer technologies related to ECMO use, examine recent observational studies and randomized trials of ECMO use before and after lung transplantation, and reflect upon our own institutional experience with the use of ECMO in these difficult clinical situations.

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Published In

J Thorac Dis

DOI

ISSN

2072-1439

Publication Date

August 2014

Volume

6

Issue

8

Start / End Page

1070 / 1079

Location

China

Related Subject Headings

  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
 

Citation

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ICMJE
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Gulack, B. C., Hirji, S. A., & Hartwig, M. G. (2014). Bridge to lung transplantation and rescue post-transplant: the expanding role of extracorporeal membrane oxygenation. J Thorac Dis, 6(8), 1070–1079. https://doi.org/10.3978/j.issn.2072-1439.2014.06.04
Gulack, Brian C., Sameer A. Hirji, and Matthew G. Hartwig. “Bridge to lung transplantation and rescue post-transplant: the expanding role of extracorporeal membrane oxygenation.J Thorac Dis 6, no. 8 (August 2014): 1070–79. https://doi.org/10.3978/j.issn.2072-1439.2014.06.04.
Gulack, Brian C., et al. “Bridge to lung transplantation and rescue post-transplant: the expanding role of extracorporeal membrane oxygenation.J Thorac Dis, vol. 6, no. 8, Aug. 2014, pp. 1070–79. Pubmed, doi:10.3978/j.issn.2072-1439.2014.06.04.

Published In

J Thorac Dis

DOI

ISSN

2072-1439

Publication Date

August 2014

Volume

6

Issue

8

Start / End Page

1070 / 1079

Location

China

Related Subject Headings

  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences