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体外膜肺氧合作为土耳其肺移植计划中肺移植的桥梁:我们的初步经验。

Extracorporeal membrane oxygenation as a bridge to lung transplantation in a Turkish lung transplantation program: our initial experience.

机构信息

Thoracic Surgery, Kartal Kosuyolu Training and Research Hospital, K Blok Cevizli, Kartal, Istanbul, Turkey.

Infectious Diseases, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey.

出版信息

J Artif Organs. 2021 Mar;24(1):36-43. doi: 10.1007/s10047-020-01204-w. Epub 2020 Aug 27.

Abstract

Lung transplantation is a life-saving treatment for patients with end-stage lung disease. Although the number of lung transplants has increased over the years, the number of available donor lungs has not increased at the same rate, leading to the death of transplant candidates on waiting lists. In this paper, we presented our initial experience with the use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation. Between December 2016 and August 2018, we retrospectively reviewed the use of ECMO as a bridge to lung transplantation. Thirteen patients underwent preparative ECMO for bridging to lung transplantation, and seven patients successfully underwent bridging to lung transplantation. The average age of the patients was 45.7 years (range, 19-62 years). The ECMO support period lasted 3-55 days (mean, 18.7 days; median, 13 days). In seven patients, bridging to lung transplantation was performed successfully. The mean age of patients was 49.8 years (range 42-62). Bridging time was 3-55 days (mean, 19 days; median, 13 days). Two patients died in the early postoperative period. Five patients survived until discharge from the hospital. One-year survival was achieved in four patients. ECMO can be used safely for a long time to meet the physiological needs of critically ill patients. The use of ECMO as a bridge to lung transplantation is an acceptable treatment option to reduce the number of deaths on the waiting list. Despite the successful results achieved, this approach still involves risks and complications.

摘要

肺移植是治疗终末期肺病患者的一种救生治疗方法。尽管近年来肺移植的数量有所增加,但可供使用的供体肺数量并没有以同样的速度增加,导致等待名单上的移植候选人死亡。在本文中,我们介绍了使用体外膜肺氧合(ECMO)作为肺移植桥接的初步经验。在 2016 年 12 月至 2018 年 8 月期间,我们回顾性地审查了使用 ECMO 作为肺移植桥接的情况。13 例患者接受了 ECMO 预备桥接肺移植,7 例患者成功地进行了桥接肺移植。患者的平均年龄为 45.7 岁(范围 19-62 岁)。ECMO 支持期持续 3-55 天(平均 18.7 天;中位数 13 天)。在 7 例患者中,成功地进行了桥接肺移植。患者的平均年龄为 49.8 岁(范围 42-62)。桥接时间为 3-55 天(平均 19 天;中位数 13 天)。2 例患者在术后早期死亡。5 例患者存活至出院。4 例患者实现了 1 年生存率。ECMO 可安全使用较长时间,以满足重症患者的生理需求。使用 ECMO 作为肺移植桥接是一种可以接受的治疗选择,可以减少等待名单上的死亡人数。尽管取得了成功的结果,但这种方法仍然存在风险和并发症。

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[Extracorporeal membrane oxygenation as a bridge to lung transplantation].[体外膜肺氧合作为肺移植的桥梁]
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本文引用的文献

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Outcomes of Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplantation.体外膜肺氧合作为肺移植桥接的结果。
Ann Thorac Surg. 2019 May;107(5):1456-1463. doi: 10.1016/j.athoracsur.2019.01.032. Epub 2019 Feb 18.
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Ventilator-induced Lung Injury.呼吸机相关性肺损伤
Clin Chest Med. 2016 Dec;37(4):633-646. doi: 10.1016/j.ccm.2016.07.004. Epub 2016 Oct 14.

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