This study compared differences in patient outcomes and operative parameters for extracorporeal membrane oxygenation (ECMO) versus cardiopulmonary bypass (CPB) in patients undergoing lung transplants.
Methods
Between January 1, 2008, and July 13, 2013, 316 patients underwent lung transplants at our institution, 102 requiring intraoperative mechanical cardiopulmonary support (CPB, n = 55; ECMO, n = 47). We evaluated survival, blood product transfusions, bleeding complications, graft dysfunction, and rejection.
Results
Intraoperatively, the CPB group required more cell saver volume (1123 ± 701 vs 814 ± 826 mL; P = .043), fresh-frozen plasma (3.64 ± 5.0 vs 1.51 ± 3.2 units; P = .014), platelets (1.38 ± 1.6 vs 0.43 ± 1.25 units; P = .001), and cryoprecipitate (4.89 ± 6.3 vs 0.85 ± 2.8 units; P < .001) than the ECMO group. Postoperatively, the CPB group received more platelets (1.09 ± 2.6 vs 0.13 ± 0.39 units; P = .013) and was more likely to have bleeding (15 [27.3%] vs 3 [6.4%]; P = .006) and reoperation (21 [38.2%] vs 7 [14.9%]; P = .009]. The CPB group had higher rates of primary graft dysfunction at 24 and 72 hours (41 [74.5%] vs 23 [48.9%]; P = .008; and 42 [76.4%] vs 26 [56.5%]; P = .034; respectively). There were no differences in 30-day and 1-year survivals.
Conclusions
Relative to CPB, the ECMO group required fewer transfusions and had less bleeding, fewer reoperations, and less primary graft dysfunction. There were no statistically significant survival differences at 30 days or 1 year.
CTSNet classification
12
27.1
Abbreviations and Acronyms
CPB
cardiopulmonary bypass
ECMO
extracorporeal membrane oxygenation
PGD
primary graft dysfunction
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Disclosures: Matthew Bacchetta has consulted for Maquet Inc under a nonremuneration agreement. All other authors have nothing to disclose with regard to commercial support.
