Background And Objective: The utilization of extracorporeal life support (ECLS) as a bridge to lung transplantation (LTx) has rapidly expanded over recent years in highly urgent patients even though the reported outcomes in current literature are still divergent. The aim of our narrative review was to provide a comprehensive picture on the peri and post-operative outcomes of patients bridged to LTx with this device from the most updated literature in the field.
Methods: The literature about ECLS bridge to LTx was searched on PubMed using a formal strategy. We focused our research on studies published between 2015 and 2022 and in English language. Abstracts, case reports, conference presentations, editorials, expert opinions and review articles were excluded.
Key Content And Findings: ECLS has emerged as a valid tool to bridge critically ill patients to LTx. Some issues, like the selection of candidates and the post-operative outcomes, are still matter of debate in the current reported series. We analyzed 14 papers published in the last seven years and with at least 20 patients to provide an updated overview on this topic. We found that, in highly experienced centers, ECLS can be used as a good strategy to allow critically ill patients to remain eligible to LTx with satisfying post-operative outcomes.
Conclusions: Specific scores and algorithms should be implemented to improve the selection process of candidates who could benefit more from ECLS as a bridge to LTx. Ambulatory/awake ECLS strategies should be always preferred to enroll patients in active rehabilitation programs awaiting LTx, improving short and long-term outcomes and increasing the success of LTx.
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http://dx.doi.org/10.21037/jtd-22-1163 | DOI Listing |
J Cardiothorac Surg
January 2025
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
Background: Left ventricular unloading is needed in patients on extracorporeal life support (ECLS) with severely impaired left ventricular contractility to avoid stasis and pulmonary congestion, and to promote LV recovery. The presence of thrombi in the LV precludes the use of conventional active unloading methods such as transaortic microaxial pumps or apical LV vents. We describe placement of a vent cannula via the left atrial appendage (LAA) as a useful bailout option.
View Article and Find Full Text PDFBest Pract Res Clin Gastroenterol
December 2024
Department of Critical Care Medicine, University of Alberta, Edmonton, Canada; Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada. Electronic address:
Perfusion
October 2024
Department of Anesthesiology and Intensive Care, Philipps University, Marburg, Germany.
ASAIO J
September 2024
Department of Surgery and ECLS Laboratory, University of Michigan Medical School, Ann Arbor, MI.
J Heart Lung Transplant
January 2025
Division of Cardiac Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York. Electronic address:
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