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Bridges to lung transplantation
1Department of Cardiothoracic Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. strueber.martin@mh-hannover.de
Current Opinion in Organ Transplantation
|September 8, 2011
Summary
Extracorporeal membrane oxygenation (ECMO) is evolving as a bridge to lung transplantation, shifting from supporting ventilation to potentially replacing it. This advancement aims to improve patient outcomes before surgery.
Area of Science:
- Cardiovascular and Respiratory Medicine
- Transplantation Science
- Medical Technology Innovation
Background:
- Bridging to lung transplantation using extracorporeal support is debated due to potential selection of high-risk patients.
- Advancements in extracorporeal device technology may alter indications and outcomes.
Purpose of the Study:
- To review recent advancements in extracorporeal gas exchange technologies for bridging to lung transplantation.
- To define the current status and impact of these technologies on transplantation strategies.
Main Methods:
- A literature review of the past three years focusing on extracorporeal membrane oxygenation (ECMO) for bridging to lung transplantation.
- Analysis of new oxygenator and pump designs and their clinical applications.
Main Results:
- Miniaturized ECMO systems have emerged due to new oxygenator and pump technologies.
- Specific indications for ECMO use have been described, with a trend towards avoiding mechanical ventilation.
- A paradigm shift is occurring, with ECMO being used to avoid or wean from ventilation.
Conclusions:
- Bridging strategies for lung transplantation are evolving towards methods that avoid mechanical ventilation.
- This shift aims to improve the condition of lung transplant recipients before transplantation.
