Improved Results Over Time With Bridge-to-Lung Transplantation: A 10-Year Experience of a Single High-Volume Center.

IF 2.7 3区医学 Q1 SURGERY

Transplant International Pub Date : 2025-01-30 eCollection Date: 2025-01-01 DOI:10.3389/ti.2025.13944

Gyungah Kim, Jee Hwan Ahn, Tae Sun Shim, Pil-Je Kang, Geun Dong Lee, Sehoon Choi, Won Kim, Sung-Ho Jung, Dong Kwan Kim, Seung-Il Park, Sang-Bum Hong

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Abstract

When donor scarcity limits timely lung transplantation (LTx), extracorporeal membrane oxygenation (ECMO) as a bridge to transplantation (BTT) can prolong survival and delay deconditioning until the donor lungs become available. We reviewed 10-year BTT experiences of a single high-volume center, where 99 (59%) were on ECMO BTT among 169 eligible adult LTx cases. Both 28-day and 2-year survivals did not differ between BTT and non-BTT. The BTT data was then divided into two periods, delineated by the most recent 3 years. The clinical outcomes of the earlier period ("Period 1") and the later period ("Period 2") were compared, and mortality within 28 days of LTx was significantly lower in Period 2 (n = 1, 1.7%) than in Period 1 (n = 6, 14.6%, p < 0.01). Improved survival was observed in the subgroup with BTT duration of 14 days or more. Taken together, more experiences in BTT and improved competence may contribute to better survival after LTx, especially in patients receiving ECMO for 14 days or more.

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随着时间的推移，桥肺移植的改善效果：一个单一大容量中心的10年经验。

当供体稀缺限制了及时的肺移植（LTx）时，体外膜氧合（ECMO）作为移植（BTT）的桥梁可以延长生存时间并延迟去适应，直到供体肺可用。我们回顾了一个大容量中心10年的BTT经验，在169例符合条件的成人LTx病例中，有99例（59%）接受了ECMO BTT。BTT与非BTT的28天和2年存活率均无差异。然后将BTT数据分为两个时期，按最近3年划分。比较早期（“第1期”）和晚期（“第2期”）的临床结果，LTx治疗后28 d内死亡率2期（n = 1, 1.7%）明显低于第1期（n = 6, 14.6%, p < 0.01）。BTT持续14天或更长时间的亚组观察到生存改善。综上所述，更多的BTT经验和能力的提高可能有助于LTx后更好的生存，特别是对于接受ECMO 14天或更长时间的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant International 医学-外科

CiteScore

4.70

自引率

6.50%

发文量

211

审稿时长

3-8 weeks

期刊介绍： The aim of the journal is to serve as a forum for the exchange of scientific information in the form of original and high quality papers in the field of transplantation. Clinical and experimental studies, as well as editorials, letters to the editors, and, occasionally, reviews on the biology, physiology, and immunology of transplantation of tissues and organs, are published. Publishing time for the latter is approximately six months, provided major revisions are not needed. The journal is published in yearly volumes, each volume containing twelve issues. Papers submitted to the journal are subject to peer review.