Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review
Background. Lung transplant (LTx) waitlists continue to grow internationally. Consequently, more patients are progressing to require mechanical circulatory support (MCS) as a bridge to transplantation (BTT). MCS strategies include interventional lung assist (iLA) and venovenous (VV) and venoarterial...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2017/5947978 |
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| author | Katie Kinaschuk Sabin J. Bozso Kieran Halloran Ali Kapasi Kathy Jackson Jayan Nagendran |
| author_facet | Katie Kinaschuk Sabin J. Bozso Kieran Halloran Ali Kapasi Kathy Jackson Jayan Nagendran |
| author_sort | Katie Kinaschuk |
| collection | DOAJ |
| description | Background. Lung transplant (LTx) waitlists continue to grow internationally. Consequently, more patients are progressing to require mechanical circulatory support (MCS) as a bridge to transplantation (BTT). MCS strategies include interventional lung assist (iLA) and venovenous (VV) and venoarterial (VA) extracorporeal membrane oxygenation (ECMO). We review our series of patients bridged with MCS while listed for LTx. Methods. All consecutive patients, listed for LTx requiring MCS as a BTT at the University of Alberta from 2004 to 2015, were included. Patient demographics and outcomes were compared for the 3 groups (iLA, VV-ECMO, and VA-ECMO). Results. Of the 24 patients supported with MCS devices, 17 were successfully transplanted and 7 died waiting. In total, 25% (n=6) were bridged with VA-ECMO, 54% (n=13) with VV-ECMO, and 21% (n=5) with iLA. Overall, 71% of patients were bridged successfully to LTx. The 1-year survival posttransplantation was 88%. Conclusion. We have demonstrated the feasibility of utilizing the MCS modalities of VA-ECMO, VV-ECMO, and most recently iLA, as a BTT. MCS is a viable strategy for BTT, offering improved survival outcomes for decompensating adult patients awaiting LTx, resulting in excellent survival posttransplantation. |
| format | Article |
| id | doaj-art-4e8843e488b84549a8760dbf54dab434 |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-4e8843e488b84549a8760dbf54dab4342025-08-20T03:36:39ZengWileyCanadian Respiratory Journal1198-22411916-72452017-01-01201710.1155/2017/59479785947978Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution ReviewKatie Kinaschuk0Sabin J. Bozso1Kieran Halloran2Ali Kapasi3Kathy Jackson4Jayan Nagendran5Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, CanadaDepartment of Surgery, Division of Cardiac Surgery, Edmonton, AB, CanadaDepartment of Medicine, University of Alberta, Edmonton, AB, CanadaDepartment of Medicine, University of Alberta, Edmonton, AB, CanadaHuman Organ Procurement and Exchange Program, Edmonton, AB, CanadaDepartment of Surgery, Division of Cardiac Surgery, Edmonton, AB, CanadaBackground. Lung transplant (LTx) waitlists continue to grow internationally. Consequently, more patients are progressing to require mechanical circulatory support (MCS) as a bridge to transplantation (BTT). MCS strategies include interventional lung assist (iLA) and venovenous (VV) and venoarterial (VA) extracorporeal membrane oxygenation (ECMO). We review our series of patients bridged with MCS while listed for LTx. Methods. All consecutive patients, listed for LTx requiring MCS as a BTT at the University of Alberta from 2004 to 2015, were included. Patient demographics and outcomes were compared for the 3 groups (iLA, VV-ECMO, and VA-ECMO). Results. Of the 24 patients supported with MCS devices, 17 were successfully transplanted and 7 died waiting. In total, 25% (n=6) were bridged with VA-ECMO, 54% (n=13) with VV-ECMO, and 21% (n=5) with iLA. Overall, 71% of patients were bridged successfully to LTx. The 1-year survival posttransplantation was 88%. Conclusion. We have demonstrated the feasibility of utilizing the MCS modalities of VA-ECMO, VV-ECMO, and most recently iLA, as a BTT. MCS is a viable strategy for BTT, offering improved survival outcomes for decompensating adult patients awaiting LTx, resulting in excellent survival posttransplantation.http://dx.doi.org/10.1155/2017/5947978 |
| spellingShingle | Katie Kinaschuk Sabin J. Bozso Kieran Halloran Ali Kapasi Kathy Jackson Jayan Nagendran Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review Canadian Respiratory Journal |
| title | Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review |
| title_full | Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review |
| title_fullStr | Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review |
| title_full_unstemmed | Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review |
| title_short | Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review |
| title_sort | mechanical circulatory support as a bridge to lung transplantation a single canadian institution review |
| url | http://dx.doi.org/10.1155/2017/5947978 |
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