Science and Research

Recent advances in extracorporeal life support as a bridge to lung transplantation

INTRODUCTION: Invasive mechanical respiratory support in candidate bridging to transplant (BTT) has become common practice in recent years. This usually consists of mechanical ventilation, extracorporeal life support (ECLS) or a combination of both techniques. Areas covered: This review covers epidemiology, technical considerations, indications and outcome of ELCS as BTT. Published literature was identified by searching the MEDLINE bibliographic database (1946-present) and appropriate papers were reviewed. In a retrospective analysis of the period 2010-2016 (n = 92 cases of ECLS bridging, 62% ECLS only) at our institution, bridging success was 73%, with 1-year survival among patients surviving to transplant 78%, surpassing our previously published results between 2005-2009 (bridging success 58%, 1-year survival 58%, p = 0.002 and p = 0.02, respectively). Expert commentary: While ECLS success has influenced lung transplant selection criteria, bridging remains technically and ethically challenging. Candidate selection and organ allocation are crucial to achieving acceptable results.

  • Gottlieb, J.
  • Greer, M.

Keywords

  • *Extracorporeal Membrane Oxygenation
  • Humans
  • *Lung Transplantation
  • Patient Selection
  • *Respiration, Artificial
  • Respiratory Insufficiency/diagnosis/etiology/*therapy
  • *bridge to transplant
  • *clinical ethics
  • *critical care
  • *life support systems
  • *lung allocation score
  • *mechanical ventilation
  • *morbidity
  • *survival
Publication details
DOI: 10.1080/17476348.2018.1433035
Journal: Expert review of respiratory medicine
Pages: 217-225 
Number: 3
Work Type: Review
Location: BREATH
Disease Area: ROR
Partner / Member: MHH
Access-Number: 29369703
See publication on PubMed

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