Journal article
Survey of Extracorporeal Life Support Application in Lung Transplantation
Clinical transplantation, Vol.39(2), e70094
02/2025
DOI: 10.1111/ctr.70094
PMID: 39918447
Abstract
Lung transplantation has been evolving since its inception in 1963. Over recent years, literature has suggested a shift in the perioperative strategy of mechanical support toward extracorporeal membrane oxygenation (ECMO) as the preferred modality of extracorporeal life support (ECLS) in lung transplantation. The Survey of ECLS Application in Lung transplantation (SEAL) was designed to elucidate the current practice patterns of perioperative ECLS within the United States.
In this cross-sectional study, a physician from 62 adult lung transplantation centers across the United States of America (USA) was surveyed on their institutional practices regarding the perioperative management of lung transplantation patients, with a focus on mechanical support.
The survey completion rate was 74% (46/62 eligible institutions). Most transplant centers utilize venoarterial (VA) ECMO (78%, 36/46) and/or venovenous (VV) ECMO (93%, 29/43) as a bridge to lung transplantation. When ECLS is used intraoperatively, 61% of (28/46) responding programs use VA ECMO as their preferred support. All programs use transesophageal echocardiography (TEE) intraoperatively, 85% (33/39) cannulate for ECMO centrally, and 74% (29/39) use a combination of inhaled and intravenous anesthesia while using ECMO intraoperatively. Most programs do not use antifibrinolytic during VA ECMO (62%, 28/45). Anticoagulation management and VA ECMO flows throughout the procedure showed considerable variation.
Data from SEAL illustrates that though there are some practice commonalities within the United States, there is also quite a bit of variability in practice. Multiple dominant practices within the USA are consistent with a recently published International Society of Heart and Lung Transplantation consensus.
Details
- Title: Subtitle
- Survey of Extracorporeal Life Support Application in Lung Transplantation
- Creators
- Barbara Jeanne Wilkey - University of Colorado DenverTyler Elliott - Florida CollegeTodd Everett Jones - Florida CollegeTerrie Vasilopoulos - Florida CollegeTheresa Gelzinis - University of Pittsburgh Medical CenterMelissa Bellomy - The University of Texas Southwestern Medical CenterJessica Louise Brodt - Stanford MedicineJoshua Knight - University of Pittsburgh Medical CenterMariya Atanassova Geube - Cleveland ClinicJohn Michael Fox - Tufts Medical CenterChristopher Lee Racine - University of Alabama at BirminghamJustin Nadeem Tawil - University of Wisconsin–MadisonKatharine Kozarek - University of Wisconsin–MadisonSudhakar Subramani - University of Iowa Health CareKara Kimberly Siegrist - Vanderbilt University Medical CenterPratik Kothary - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellYong Gang Peng - Florida CollegeAndrea Nicole Miltiades - Columbia University Irving Medical CenterSharon Lorraine McCartney - Duke UniversityBrandi Anne Bottiger - Duke UniversityArcher Kilbourne Martin - Mayo Clinic in Florida
- Resource Type
- Journal article
- Publication Details
- Clinical transplantation, Vol.39(2), e70094
- Publisher
- Wiley; HOBOKEN
- DOI
- 10.1111/ctr.70094
- PMID
- 39918447
- ISSN
- 1399-0012
- eISSN
- 1399-0012
- Grant note
- Society for the Advancement of Transplant Anesthesia
The authors would like to thank the following for their contributions to this project: The Society for the Advancement of Transplant Anesthesia, The Society of Cardiovascular Anesthesiologists, Jesse Ream, Subhasis Chatterjee, Stephanie Yacoubian, Abirami Kumaresan, Andrew Greenwald, Brian Trethowan, Trevor Szymanski, Elizabeth Harrera, Edwin Becher, Christopher King, Megan Kostibas, Michael Haske, Juan Ripoll Sanz, Marc Stone, Annabelle Levine, Jennie Ngai, Manoj Iyer, Gundars Katlapsl, Norihisa Shigemura, Emily Methangkool, Dalia Banks, Wilson Cui, Gregory Janelle, Benjamin Leahy, Sam Mondal, Mauricio Pipkin, Anna Dubovoy, Andrew Wilkey, Megan Chacon, Daniel Rosenkrans, Regina Linganna, Marie McHenry, John McNeil, Katelyn Devine, John Dollerschell, Marie McHenry, and Ziyan Song. There was no funding for this project. There are no known relevant disclosures.
- Language
- English
- Date published
- 02/2025
- Academic Unit
- Anesthesia
- Record Identifier
- 9984786308602771
Metrics
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