Original articleGeneral thoracicExtracorporeal Circulatory Systems as a Bridge to Lung Transplantation at Remote Transplant Centers
Section snippets
Patients and Methods
Between January 2003 and December 2009, the Department of Cardiothoracic Surgery, University Medical Center, Regensburg, Germany, had 10 requests for implantation of ECS as a bridge to LTx in patients with ventilator-refractory hypoxemia or hypercapnia with accompanying severe respiratory acidosis. After approval by the local Ethics Committee, we reviewed data of these 10 patients.
Patients from regional hospitals who were potential ECS candidates were transferred to our center. If the patients
Results
During the observation period, 10 patients were considered for bridge to LTx. Eight patients were successfully implanted with an ECS device at our center. Two patients from outside hospitals were too unstable for conventional transport, and were placed on ECS at the referring hospital and then transported to our institution on active ECS. Patient characteristics are given in Table 1. The median age was 36 years (range, 24 to 53), and 70% were female. Before ECS implantation, all patients were
Comment
“Bridging” patients to LTx by extracorporeal devices has a history. In 1975, the first case of ECMO as a bridge to lung transplant was performed for posttraumatic respiratory failure [15]. In 1991, the Hannover group published the first report of long-term survival after using ECMO as a bridge to redo lung transplant [16]. From 1975 to the early 1990s, 7 patients underwent lung transplantation after ECMO application for acute severe respiratory failure, with disparate results [15, 16, 17].
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