Clinical lung and heart/lung transplantationMedium-term results of extracorporeal membrane oxygenation for severe acute lung injury after lung transplantation
Section snippets
Patients
The institutional review board at the University of Minnesota approved the study protocol and all patients consented to a review of their medical records. All patients who underwent lung transplantation from January 1997 to December 2002 were eligible for the study. Transplant evaluations and hospital charts were reviewed. Data collected included pre-operative patient demographic characteristics, pulmonary function tests, echocardiograms and cardiac catheterizations as well as hemodynamic,
Results
During the 5-year study period, we performed 171 lung transplant procedures using cadaveric organs; 98 patients received single lungs (57%) and 73 received bilateral single lungs (43%). Indications for transplantation were chronic obstructive pulmonary disease (COPD) or α 1-anti-trypsin deficiency in 106 patients (64%), idiopathic pulmonary fibrosis (IPF) in 17 (10%), primary pulmonary hypertension (PPH) in 10 (6%), cystic fibrosis (CF) in 18 (11%) and miscellaneous indications in 15 (9%). The
Discussion
Primary allograft failure is the major cause of early mortality and morbidity after lung transplantation, and severe ischemia—reperfusion injury is the most common etiologic factor associated with the syndrome. In addition to their peri-operative problems, patients that survive PGF may have reduced pulmonary function and may be at an increased risk for acute and chronic rejection.3 Depending on the criteria used for diagnosis, the reported incidence of PGF ranges from 20% to 57%.4, 5, 6 Risk
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