Hurley Caitlin, Di Nardo Matteo, Rees Matthew, Hijano Diego R, Said Ahmed, Sharma Akshay, Elbahlawan Lama, Hines Melissa R, McArthur Jennifer A, Sandhu Hitesh, Ghafoor Saad
Department of Pediatric Medicine, Division of Critical Care Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States.
Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, United States.
Front Oncol. 2025 Jun 18;15:1588403. doi: 10.3389/fonc.2025.1588403. eCollection 2025.
Extra Corporeal Life Support (ECLS) for pediatric oncology and stem cell transplant patients over the past two decades has made progress. Substantial improvements in ECLS, Continuous Renal Replacement Therapy (CRRT), and mechanical ventilation techniques, along with enhanced anticoagulation management and infection control, have contributed to better patient outcomes. Additionally, advancements in HLA matching, donor selection, and the management of chemotherapy and transplant complications have further improved survival rates. The authors propose establishing an expert team and a standardized process to evaluate ECLS candidacy, addressing past controversies and optimizing outcomes for this vulnerable population. The criteria for candidacy have evolved significantly, necessitating expert evaluation.
在过去二十年中，针对儿科肿瘤学和干细胞移植患者的体外生命支持（ECLS）取得了进展。ECLS、连续性肾脏替代疗法（CRRT）和机械通气技术的显著改进，以及抗凝管理和感染控制的加强，都有助于改善患者的治疗效果。此外，人类白细胞抗原（HLA）配型、供体选择以及化疗和移植并发症管理方面的进展进一步提高了生存率。作者建议组建一个专家团队并制定标准化流程，以评估ECLS的适用性，解决过去的争议并优化这一弱势群体的治疗结果。ECLS适用性标准已经有了显著变化，因此需要专家评估。
