Faccioli E, Terzi S, Pangoni A, Lomangino I, Rossi S, Lloret A, Cannone G, Marino C, Catelli C, Dell'Amore A. Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results. World J Transplant 2021; 11(7): 290-302 [PMID: 34316453 DOI: 10.5500/wjt.v11.i7.290]
Corresponding Author of This Article
Andrea Dell'Amore, MD, Professor, Thoracic Surgery Unit, Department of Cardiothoracic and Vascular Sciences, University of Padova, Via G Verci 8, Padova 35128, Italy. andrea.dellamore@unipd.it
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jul 18, 2021; 11(7): 290-302 Published online Jul 18, 2021. doi: 10.5500/wjt.v11.i7.290
Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results
Eleonora Faccioli, Stefano Terzi, Alessandro Pangoni, Ivan Lomangino, Sara Rossi, Andrea Lloret, Giorgio Cannone, Carlotta Marino, Chiara Catelli, Andrea Dell'Amore
Eleonora Faccioli, Stefano Terzi, Alessandro Pangoni, Ivan Lomangino, Sara Rossi, Andrea Lloret, Giorgio Cannone, Carlotta Marino, Chiara Catelli, Andrea Dell'Amore, Thoracic Surgery Unit, Department of Cardiothoracic and Vascular Sciences, University of Padova, Padova 35128, Italy
Author contributions: Faccioli E, Dell'Amore A contributed to conceptualization and writing, Terzi S, Pangoni A designed the research study; Lomangino I, Loret A performed the research; Rossi S, Carlotta M Catelli C contributed to review analysis; Cannone G, edited the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: Authors have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrea Dell'Amore, MD, Professor, Thoracic Surgery Unit, Department of Cardiothoracic and Vascular Sciences, University of Padova, Via G Verci 8, Padova 35128, Italy. andrea.dellamore@unipd.it
Received: March 4, 2021 Peer-review started: March 4, 2021 First decision: March 31, 2021 Revised: April 13, 2021 Accepted: May 25, 2021 Article in press: May 25, 2021 Published online: July 18, 2021
Abstract
The use of extracorporeal membrane oxygenation (ECMO) in the field of lung transplantation has rapidly expanded over the past 30 years. It has become an important tool in an increasing number of specialized centers as a bridge to transplantation and in the intra-operative and/or post-operative setting. ECMO is an extremely versatile tool in the field of lung transplantation as it can be used and adapted in different configurations with several potential cannulation sites according to the specific need of the recipient. For example, patients who need to be bridged to lung transplantation often have hypercapnic respiratory failure that may preferably benefit from veno-venous (VV) ECMO or peripheral veno-arterial (VA) ECMO in the case of hemodynamic instability. Moreover, in an intra-operative setting, VV ECMO can be maintained or switched to a VA ECMO. The routine use of intra-operative ECMO and its eventual prolongation in the post-operative period has been widely investigated in recent years by several important lung transplantation centers in order to assess the graft function and its potential protective role on primary graft dysfunction and on ischemia-reperfusion injury. This review will assess the current evidence on the role of ECMO in the different phases of lung transplantation, while analyzing different studies on pre, intra- and post-operative utilization of this extracorporeal support.
Core Tip: Extracorporeal membrane oxygenation (ECMO) is the most used support in lung transplantation as it allows a complete spectrum of support (blood oxygenation, decarboxylation and cardiocirculatory support). Due to its versatility it can be used in a pre-operative setting (bridge to transplantation) and might be prolonged intra- and/or post-operatively. All these factors, in combination with a growing experience in its use in lung transplantation, usually in a multidisciplinary team, has resulted in good outcomes derived from several experiences reported in the literature by high-volume transplant centers. This paper aims to systematically review current evidence on pre, intra and post-operative ECMO in lung transplantation.
