Bozso S, Sidhu S, Garg M, Freed D H, Nagendran J
Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
Transplant Proc. 2015 Jan-Feb;47(1):186-9. doi: 10.1016/j.transproceed.2014.10.039.
Extracorporeal membrane oxygenation (ECMO) is a method of enabling gas exchange through an external membrane used to treat respiratory failure in critically ill patients. ECMO as a bridge to lung transplantation has been investigated as a potential method of reducing lung transplantation waitlist mortality. Herein we describe a case of ECMO as a bridge-to-lung transplantation for the duration of 35 days, which is the longest documented length of ECMO support before successful transplantation in Canada.
The prospective recipient was a 28-year-old female suffering from stage 4 pulmonary sarcoidosis. Given an acute exacerbation of her chronic respiratory failure, ECMO had to be initiated. She remained on ECMO for 35 days until a suitable set of donor lungs became available. The recipient had a prolonged course in hospital but was successfully discharged home where she continues to have good lung function. She remains alive and well at home 5 months post-transplantation and continues to improve and gain strength.
Our case provides hope that in the future we may be able to expand the population of recipients who may be candidates for lung transplantation. This case adds to the growing literature on the role of ECMO as a bridge-to-lung transplantation with the potential to reduce patient deaths while wait-listed for lung transplantation as well as increase the number of transplantations being performed.
体外膜肺氧合（ECMO）是一种通过外部膜实现气体交换的方法，用于治疗危重症患者的呼吸衰竭。ECMO作为肺移植的桥梁，已被研究作为降低肺移植等待名单死亡率的一种潜在方法。在此，我们描述了一例ECMO作为肺移植桥梁持续35天的病例，这是加拿大有记录以来在成功移植前ECMO支持最长的时长。
预期受者是一名患有4期肺结节病的28岁女性。由于其慢性呼吸衰竭急性加重，不得不启动ECMO。她在ECMO上维持了35天，直到获得合适的供体肺。受者在医院经历了漫长的病程，但最终成功出院回家，目前肺功能良好。移植后5个月，她在家中仍然存活且状况良好，并且持续改善、体力增强。
我们的病例表明，未来或许能够扩大肺移植候选受者群体。该病例为关于ECMO作为肺移植桥梁作用的文献增添了内容，其有可能减少肺移植等待名单上患者的死亡，并增加肺移植手术的数量。
