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- Title
Extracorporeal Membrane Oxygenation (ECMO) in Heart or Lung Transplantation.
- Authors
Zirak, N.; Rezayat, A. Akhavan; Ghorbanzadeh, A.; Tashnizi, M. Abassi
- Abstract
Heart or lung transplants often used in patients with end-stage heart or lung disease. Organ transplantation has improved because of surgical technique and post-operative care, improvement in the treatment, prevention of opportunistic infections and suitable donor organs. The median survival rate for heart and lung transplantations, respectively, are 11 and 5.7 years. The major causes of early death (the first year) after transplantation include primary graft failure, infection, and rejection. Extracorporeal membrane oxygenation (ECMO) has been demonstrated to be beneficial in treating primary heart and lung graft dysfunction. ECMO is a technique increasingly used to provide support for the failing lung, heart or both. There are two models of ECMO. VV (venovenous)-ECMO is commonly used in respiratory failure, but VA (venoarterial)-ECMO used in heart failure. Earlier studies evaluated the outcomes of ECMO in patients with lung and heart transplantation. The first ECMO was associated with poor survival, but in the past 30 years, recent technological developments such as new oxygenator materials and centrifugal pumps have led to a decrease in inflammatory response and hemolysis; in the meantime ECMO allows more prolonged support time without the physiological derangements. Several studies indicated better outcomes in patients using ECMO heart or lung transplant recipients with critical conditions. ECMO may be useful as a recovery strategy in HTx patients with graft-failure or respiratory failure while patients are waiting for the organ and after transplantation. Utilization of ECMO in the USA is increasing quickly and created an evolutionary change in saving lives. In Iran, ECMO is a new technique and its usage has many limitations such as lack of teamwork skills and special equipment, its price and consumer goods. Therefore having the ability to use the ECMO for heart-lung transplant centers seems to be necessary.
- Subjects
HEART transplantation; LUNG transplantation; LUNG disease treatment
- Publication
International Journal of Organ Transplantation Medicine, 2016, Vol 7, Issue 2, p124
- ISSN
2008-6490
- Publication type
Abstract