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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Related Experiment Video

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Intraoperative Extracorporeal Life Support for Bilateral Sequential Lung Transplantation.

Tomislav Kopjar1,2, Feda Dzubur2,3, Dorian Hirsl4

  • 1Department of Cardiac Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia.

Journal of Clinical Medicine
|December 11, 2025
PubMed
Summary
This summary is machine-generated.

Routine use of central venoarterial extracorporeal life support (VA ECLS) in lung transplantation is safe and feasible. This approach demonstrates low primary graft dysfunction and promising long-term survival rates for lung transplant recipients.

Keywords:
extracorporeal life supportextracorporeal membrane oxygenationlung transplantationprimary graft dysfunctionsurvival

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Area of Science:

  • Cardiovascular Surgery
  • Pulmonary Medicine
  • Transplant Surgery

Background:

  • Intraoperative venoarterial extracorporeal life support (VA ECLS) traditionally supports unstable lung transplant patients.
  • Emerging evidence suggests potential benefits of routine intraoperative VA ECLS for all lung transplant recipients.

Purpose of the Study:

  • To evaluate the safety and feasibility of routine central VA ECLS during lung transplantation.

Main Methods:

  • Single-center retrospective observational study (April 2021-September 2025).
  • Included consecutive lung transplant patients utilizing central VA ECLS.
  • Assessed early outcomes and primary graft dysfunction (PGD) using ISHLT criteria at 72 hours.
  • Reported survival and chronic lung allograft dysfunction (CLAD)-free survival via Kaplan-Meier estimates.

Main Results:

  • 35 patients successfully transplanted with central VA ECLS; no ECLS-related complications.
  • Low incidence of severe PGD (11.4%) at 72 hours.
  • 1-year, 3-year, and 5-year survival rates: 85%, 74%, 67%.
  • 1-year, 3-year, and 5-year CLAD-free survival rates: 82%, 52%, 36%.

Conclusions:

  • Lung transplantation with routine central VA ECLS is safe, with low PGD rates.
  • Favorable early and intermediate-term outcomes observed.
  • Further research needed for long-term inferences; technique is evolving.