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ECMO for bridging lung transplantation
Chuhan Zhang1, Qingjing Wang2, Anwei Lu3
1School of Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, People's Republic of China.
European Journal of Medical Research
|December 26, 2024
Summary
Extracorporeal membrane oxygenation (ECMO) is increasingly used to bridge lung transplantation, but challenges in patient selection and management persist. Careful patient assessment and strategy selection are vital for successful outcomes in this evolving field.
Area of Science:
- Cardiology
- Pulmonology
- Transplantation Medicine
Background:
- The Lung Allocation Score (LAS) system has increased the use of extracorporeal membrane oxygenation (ECMO) for bridging lung transplantation.
- Challenges remain in patient selection, implementation, and management of ECMO bridging lung transplantation.
Purpose of the Study:
- To review and summarize current data on ECMO bridging lung transplantation.
- To identify key factors influencing the success of ECMO bridging lung transplantation.
Main Methods:
- Extensive literature review of ECMO bridging lung transplantation data.
Main Results:
- ECMO bridging lung transplantation is more common due to improved allocation systems and ECMO technology.
- Patient selection and pre-transplant assessment are critical.
- Optimal anticoagulation strategies for ECMO are lacking, and predictive scores have limitations.
- Different bridge strategies have pros and cons, requiring individualized selection.
Conclusions:
- ECMO bridging lung transplantation is indicated for patients awaiting lung transplants when other support fails or hemodynamic instability occurs.
- Age (≥65 years) and reversible multiple organ dysfunction are not absolute contraindications.
