Lung transplantation with extracorporeal membrane oxygenation for the end stage lung disease with primary or secondary pulmonary hypertension / 中华器官移植杂志

ABSTRACT

Objective To discuss the benefits of extracorporeal membrane oxygenation (ECMO) applied in the patients with primary or secondary pulmonary hypertension during the operation of lung transplantation. Methods Thirty cases of end stage lung disease subject to primary or secondary pulmonary hypertension received lung transplantation supported with ECMO between Nov. 2005 and July 2009. The single lung transplantation was performed on 18 cases and bilateral sequential single lung transplantation on 12 cases. ECMO was used in 2 patients as a bridge to the lung transplantation to maintain 19 and 6 days respectively, and ECMO support was given during lung transplantation. ECMO was removed after the transplantation if the oxygenation and hemodynamics were stable, otherwise, ECMO was applied continuously until the situation improved. Results All the operations of these patients were accomplished successfully and the ECMO was removed in 27 patients after the operation immediately. The average time with ECMO was 6. 81 + 0. 95 h, and pulmonary artery systolic pressure after lung transplantation was 31.67 + 8. 42 mmHg. The ECMO was continuously used after lung transplantation in three patients until the hemodynamics was stable, and ECMO in 2 of them was removed at 36th h and 6th day respectively after the operation, and one,receiving postoperative ECMO for 5 days, died of acute renal failure 2 weeks after the operation.Conclusion ECMO can replace CPB safely and effectively in lung transplantations for primary or secondary pulmonary hypertension patients. As a respiratory and circulatory support it can control pulmonary hypertension during operative period and can decrease the complications of lung transplantation.