RT Book, Section
A1 Zwischenberger, Brittany A.
A1 Zwischenberger, Joseph B.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170413778
T1 ECMO in Lung Transplantation
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170413778
RD 2024/04/19
AB Extracorporeal  membrane  oxygenation  (ECMO)  has  continued  to  evolve  since  the  1950s  when  the  pioneers  of  cardiac  surgery,  Gibbon  and  Lillehei,  developed  cardiopulmonary  bypass.  While  the  cardiopulmonary  bypass  circuit  is  used  for  hours  during  cardiac  surgery,  the  ECMO  circuit  can  last  for  days  to  weeks.  For  lung  transplantation,  ECMO  is  used  pre-transplantation  for  acute  deterioration  (severe  respiratory  failure  with  hypoxia  or  hypercarbia),  bridge  to  organ  availability,  intraoperatively  for  poor  lung  function  immediately  post-transplantation,  and  post-operatively  for  acute  rejection,  infection,  and  bridge  to  re-transplantation.  An  analysis  of  United  Network  of  Organ  Sharing  (UNOS)  data  found  that  pre-transplantation  mechanical  ventilation  was  associated  with  a  twofold  higher  risk  of  death  in  the  first  6  months  after  transplant  (hazard  ratio  [HR],  1.92;  95%  confidence  interval  [CI],  1.3–2.8;  p  <  0.0005),  particularly  in  patients  with  cystic  fibrosis,  idiopathic  pulmonary  fibrosis,  and  restrictive  lung  disease.1