体外膜肺氧合作为胸腔多器官移植的桥梁。

IF 6.4 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Elbert E Heng, Aravind Krishnan, Stefan Elde, Alyssa Garrison, Moeed Fawad, Chawannuch Ruaengsri, Yasuhiro Shudo, Brandon A Guenthart, Y Joseph Woo, John W MacArthur
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引用次数: 0

摘要

背景:体外膜肺氧合(ECMO)已成为治疗多器官功能衰竭患者的重要工具,并越来越多地被用作移植的桥梁。虽然有关 ECMO 作为独立心肺移植桥梁的数据已有描述,但我们对 ECMO 作为胸腔多器官移植桥梁的新经验还不甚了解。本研究旨在调查 ECMO 作为胸腔多器官移植桥梁的时间趋势、使用情况和结果:方法:使用器官共享联合网络数据库来识别 1987 年至 2022 年间接受胸部多器官移植的成年患者。排除标准为受者年龄:在3927名接受胸部多器官移植的患者中,共有203名(5.2%)患者接受了ECMO作为移植的桥梁。在 ECMO 受者中,最常见的是心肺移植(45.8%),其次是心肾移植(34.5%)和肺肾移植(11.8%)。中位随访时间为 35.5 个月,与未接受 ECMO 桥接的多器官移植受者相比,接受 ECMO 桥接的患者未经调整的存活率有所下降(pConclusion:ECMO 越来越多地被用作胸腔多器官移植的桥接,但它与 30 天死亡率增加和长期存活率下降有关。在移植后存活 30 天的部分患者中,使用 ECMO 搭桥和未使用 ECMO 搭桥的患者的长期存活率相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Extracorporeal membrane oxygenation as a bridge to thoracic multiorgan transplantation.

Background: Extracorporeal membrane oxygenation (ECMO) has emerged as a crucial tool in the care of patients with multiorgan failure and is increasingly utilized as a bridge to transplantation. While data on ECMO as a bridge to isolated heart and lung transplantation have been described, our emerging experience with ECMO as a bridge to thoracic multiorgan transplantation is not yet well understood.

Methods: The United Network for Organ Sharing database was used to identify adult patients undergoing thoracic multiorgan transplantation between 1987 and 2022. Exclusion criteria were recipient age <18 and bridging with other non-ECMO mechanical circulatory support, Survival analysis was performed to compare outcomes between patients bridged to transplantation with ECMO and those who were not bridged.

Results: Of 3,927 patients undergoing thoracic multiorgan transplantation, a total of 203 (5.2%) patients received ECMO as a bridge to transplantation. Among ECMO recipients, patients were most commonly bridged to heart-lung (45.8%), followed by heart-kidney (34.5%), and lung-kidney transplantation (11.8%). At a median follow-up of 35.5 months, unadjusted survival among patients bridged with ECMO was decreased versus multiorgan transplant recipients who were not bridged (p < 0.001). Among patients surviving past 30 days following transplantation, conditional long-term survival was similar between ECMO and non-ECMO patients (p = 0.82).

Conclusions: ECMO is increasingly utilized as a bridge to thoracic multiorgan transplantation and is associated with increased 30 day mortality and decreased long-term survival. In select patients surviving to 30 days following transplantation, similar long-term survival is seen between patients bridged with ECMO and those not bridged.

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来源期刊
CiteScore
10.10
自引率
6.70%
发文量
1667
审稿时长
69 days
期刊介绍: The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.
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