Enhancing lung transplantation with ECMO: a comprehensive review of mechanisms, outcomes, and future considerations.

The journal of extra-corporeal technology Pub Date : 2024-12-01 Epub Date: 2024-12-20 DOI:10.1051/ject/2024023
Salman Pervaiz Butt, Vivek Kakar, Salman Abdulaziz, Nabeel Razzaq, Yasir Saleem, Arun Kumar, Fazil Ashiq, Praveen Ghisulal, Aaron Thrush, Sadaf Malik, Mairead Griffin, Mahanoor Amir, Umar Khan, Ashal Salim, Zaid Zoumot, Izanee Mydin, Yazan Aljabery, Gopal Bhatnagar, Yusuf Bayrak, Andres Obeso, Usman Ahmed
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Abstract

Background: Lung transplantation (LTx) is a critical intervention for patients with end-stage lung disease. However, challenges such as donor organ scarcity and post-transplant complications significantly affect its success. Recent advancements in Extracorporeal Membrane Oxygenation (ECMO) have shown promise in improving the outcomes and expanding eligibility for LTx.

Methods: A comprehensive literature review was conducted, focusing on studies that explore the use of ECMO in lung transplantation. A thorough search of relevant studies on ECMO and LTx was conducted using multiple scholarly databases and relevant keywords, resulting in 73 studies that met the inclusion criteria. Sources included peer-reviewed journals and clinical trial results, with emphasis on articles captured recent advancements in ECMO technology and techniques.

Results: ECMO has been crucial in supporting patients before, during, and after LTx. It serves as a bridge to transplantation by maintaining pulmonary and circulatory stability in critically ill patients awaiting donor organs. ECMO also aids in the evaluation of marginal donor lungs and supports patients through acute post-transplant complications. Recent technological advancements have improved the safety and efficacy of ECMO, further solidifying its role in LTx.

Conclusion: In conclusion, this review underscores ECMO's critical role in enhancing outcomes across all stages of lung transplantation. Its various configurations and strategies have shown promise in stabilizing critically ill patients and improving transplant success rates. Looking ahead, it's important to gather more information about the long-term outcomes and potential complications associated with ECMO use. More research and data collection will help us understand the benefits and risks better, leading to improved decision-making and patient care in this field.

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利用 ECMO 加强肺移植:机制、结果和未来考虑因素的全面回顾。
背景:肺移植(LTx)是终末期肺病患者的关键干预措施。然而,供体器官稀缺和移植后并发症等挑战严重影响了移植的成功。体外膜氧合(Extracorporeal Membrane Oxygenation, ECMO)的最新进展显示出改善预后和扩大LTx治疗资格的希望。方法:综合文献回顾,重点研究ECMO在肺移植中的应用。通过多个学术数据库和相关关键词对ECMO和LTx的相关研究进行全面检索,有73项研究符合纳入标准。来源包括同行评议的期刊和临床试验结果,重点是文章捕捉ECMO技术和技术的最新进展。结果:ECMO在LTx之前,期间和之后的支持患者至关重要。它通过维持等待供体器官的危重患者的肺和循环稳定,作为移植的桥梁。ECMO还有助于边缘供体肺的评估,并支持患者通过急性移植后并发症。最近的技术进步提高了ECMO的安全性和有效性,进一步巩固了其在LTx中的作用。结论:总之,本综述强调了ECMO在提高肺移植各阶段预后方面的关键作用。它的各种配置和策略在稳定危重病人和提高移植成功率方面显示出希望。展望未来,收集更多关于ECMO使用的长期结果和潜在并发症的信息是很重要的。更多的研究和数据收集将帮助我们更好地了解收益和风险,从而改善该领域的决策和患者护理。
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Enhancing lung transplantation with ECMO: a comprehensive review of mechanisms, outcomes, and future considerations. Failure to oxygenate during cardiopulmonary bypass; treatment options and intervention algorithm. Interaction of milrinone with extracorporeal life support. Plasmapheresis for extracorporeal membrane oxygenation (ECMO)-induced hemolysis in infants. List of JECT reviewers 2024.
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