Dahlberg P S, Prekker M E, Herrington C S, Hertz M I, Park S J
Department of Cardiovascular and Thoracic Surgery, University of Minnesota, 420 Delaware Street SE, MMC 207, Minneapolis, MN 55435, USA.
J Heart Lung Transplant. 2004 Aug;23(8):979-84. doi: 10.1016/j.healun.2003.08.021.
Extracorporeal membrane oxygenation (ECMO) has been used successfully for early, severe reperfusion injury after lung transplantation. The purposes of this study are to: (1) document the medium-term survival of patients treated with ECMO; and (2) assess the extent of recovery of their pulmonary function.
We retrospectively reviewed charts of 172 patients having lung transplants at our institution from 1997 through 2002. The group included 16 patients (9% of total; 10 bilateral, 5 single, 1 living lobar) treated with ECMO for primary allograft failure after single or bilateral single-lung transplantation. Survival and bronchiolitis obliterans syndrome (BOS)-free survival rates were calculated. Pulmonary function was assessed at 2 months, 1 year and 2 years post-transplant.
Median hospital stay was 48 days for the ECMO group and 16 days for the overall group (p < 0.05). The 90-day survival was 60% in the ECMO group, and 90% in the overall group. The 2-year survival was 46% in the ECMO group, and 69% in the overall group. Mean forced expiratory volume in 1 second (FEV(1)) in the ECMO group at 1 year was 59 +/- 13% of predicted, and at 2 years 60 +/- 15% of predicted; it was not significantly different for the overall group.
Patients treated with ECMO for primary allograft failure after lung transplantation showed acceptable medium-term survival and pulmonary function.
体外膜肺氧合（ECMO）已成功用于肺移植术后早期严重再灌注损伤。本研究的目的是：（1）记录接受ECMO治疗患者的中期生存率；（2）评估其肺功能的恢复程度。
我们回顾性分析了1997年至2002年在我院接受肺移植的172例患者的病历。该组包括16例（占总数的9%；10例双侧、5例单侧、1例活体肺叶）因单肺或双肺移植后原发性移植肺功能衰竭接受ECMO治疗的患者。计算生存率和无闭塞性细支气管炎综合征（BOS）生存率。在移植后2个月、1年和2年评估肺功能。
ECMO组的中位住院时间为48天，总体组为16天（p<0.05）。ECMO组的90天生存率为60%，总体组为90%。ECMO组的2年生存率为46%，总体组为69%。ECMO组1年时的平均第1秒用力呼气量（FEV₁）为预测值的59±13%，2年时为预测值的60±15%；总体组无显著差异。
肺移植后因原发性移植肺功能衰竭接受ECMO治疗的患者显示出可接受的中期生存率和肺功能。
