Lung Re-transplantation after prolonged veno-venous extracorporeal membrane oxygenation (ECMO) in a child with chronic lung allograft dysfunction.
Chronic Lung Allograft Dysfunction (CLAD)
ECMO
ECMO as a bridge to transplant
Lung re-transplantation
Lung transplantation
Rehabilitation
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
17 Jul 2023
17 Jul 2023
Historique:
revised:
17
05
2023
received:
14
12
2022
accepted:
03
07
2023
medline:
17
7
2023
pubmed:
17
7
2023
entrez:
17
7
2023
Statut:
aheadofprint
Résumé
Extracorporeal Membrane Oxygenation (ECMO) may be used as a bridge to lung transplantation in selected patients with end-stage respiratory failure. Historically, ECMO use in this setting has been associated with poor outcomes Puri V et.al, J Thorac Cardiovasc Surg, 140:427. More recently, technical advances and the implementation of rehabilitation and ambulation while awaiting transplantation on ECMO have led to improved surgical and post-transplant outcomes Kirkby S et.al, J Thorac Dis, 6:1024. We illustrate the case of a 6-year-old child who received prolonged ECMO support as a bridge to lung re-transplantation secondary to Chronic Lung Allograft Dysfunction (CLAD). Early rehabilitation was key in improving the overall pre-transplant conditioning during ECMO. Despite challenges associated with awake/ambulatory ECMO, the use of this strategy as a bridge to lung transplantation is feasible and has resulted in improved pre-transplant conditioning and post-transplant outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Extracorporeal Membrane Oxygenation (ECMO) may be used as a bridge to lung transplantation in selected patients with end-stage respiratory failure. Historically, ECMO use in this setting has been associated with poor outcomes Puri V et.al, J Thorac Cardiovasc Surg, 140:427. More recently, technical advances and the implementation of rehabilitation and ambulation while awaiting transplantation on ECMO have led to improved surgical and post-transplant outcomes Kirkby S et.al, J Thorac Dis, 6:1024.
METHODS
METHODS
We illustrate the case of a 6-year-old child who received prolonged ECMO support as a bridge to lung re-transplantation secondary to Chronic Lung Allograft Dysfunction (CLAD).
RESULTS
RESULTS
Early rehabilitation was key in improving the overall pre-transplant conditioning during ECMO.
CONCLUSIONS
CONCLUSIONS
Despite challenges associated with awake/ambulatory ECMO, the use of this strategy as a bridge to lung transplantation is feasible and has resulted in improved pre-transplant conditioning and post-transplant outcomes.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14579Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Puri V, Epstein D, Raithel SC, et al. Extracorporeal membrane oxygenation in pediatric lung transplantation. J Thorac Cardiovasc Surg. 2010;140:427-432.
Kirkby S, Hayes D Jr. Pediatric lung transplantation: indications and outcomes. J Thorac Dis. 2014;6:1024-1031.
Lehr CJ, Zaas DW, Cheifetz IM, Turner DA. Ambulatory extracorporeal membrane oxygenation as a bridge to lung transplantation: walking while waiting. Chest. 2015;147:1213-1218.
Chiumello D, Coppola S, Froio S, Colombo A, Del Sorbo L. Extracorporeal life support as bridge to lung transplantation: a systematic review. Crit Care. 2015;19:19.
Sweet SC. Pediatric lung transplantation. Respir Care. 2017;62:776-798.
Buckvold SM, Kinsella JP. Bleeding and thrombosis in pediatric extracorporeal membrane oxygenation. Can we improve anticoagulation strategies? Am J Respir Crit Care Med. 2017;196:676-677.
Schmidt F, Sasse M, Boehne M, et al. Concept of "awake venovenous extracorporeal membrane oxygenation" in pediatric patients awaiting lung transplantation. Pediatr Transplant. 2013;17:224-230.
Hayes D Jr, McConnell PI, Tobias JD, et al. Survival in children on extracorporeal membrane oxygenation at the time of lung transplantation. Pediatr Transplant. 2015;19:87-93.
Bermudez CA, Rocha RV, Zaldonis D, et al. Extracorporeal membrane oxygenation as a bridge to lung transplant: midterm outcomes. Ann Thorac Surg. 2011;92:1226-1231.
Abrams D, Javidfar J, Farrand E, et al. Early mobilization of patients receiving extracorporeal membrane oxygenation: a retrospective cohort study. Crit Care. 2014;18:R38.
Russo MJ, Davies RR, Hong KN, et al. Who is the high-risk recipient? Predicting mortality after lung transplantation using pretransplant risk factors. J Thorac Cardiovasc Surg. 2009;138:1234-1238.e1231.
Toprak D, Midyat L, Freiberger D, Boyer D, Fynn-Thompson F, Visner G. Outcomes of mechanical support in a pediatric lung transplant center. Pediatr Pulmonol. 2017;52:360-366.
Hayes D Jr, Benden C, Sweet SC, Conrad CK. Current state of pediatric lung transplantation. Lung. 2015;193:629-637.
Scully BB, Zafar F, Schecter MG, et al. Lung retransplantation in children: appropriate when selectively applied. Ann Thorac Surg. 2011;91:574-579.
Lin JC. Extracorporeal membrane oxygenation for severe pediatric respiratory failure. Respir Care. 2017;62:732-750.