RT Journal Article
SR Electronic
T1 Septic shock – A contraindication for bridge to transplant?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2464
VO 44
IS Suppl 58
A1 Franziska Kaestner
A1 Nicole Olewczynska
A1 Ralf Kaiser
A1 Philip Böhmer
A1 Ingo Stehle
A1 Katharina Rentz
A1 Sven Henschke
A1 Sebastian Fähndrich
A1 Hans-Joachim Schäfers
A1 Frank Langer
A1 Heinrike Wilkens
A1 Robert Bals
A1 Philipp M. Lepper
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2464.abstract
AB Aim: To show first results of patients in septic shock being bridged to lung transplantation(ltx) via extra corporal membrane oxygenation (ECMO).Methods: A retrospective, single-center study observing septic patients in 2012 and 2013taken on ECMO and being transplanted.Results: 12 patients were included, 1 died on ECMO prior to ltx, 2 died in the first dayspost transplantation. 7 were female; the mean age was 46. 5patients suffered from mucoviscidosis, 3 had fibrosis, 2 COPD and another 2 PAHrespectively bronchiectasis. The mean time on the waiting list was 15.7 month, mean lungallocation score 90 points. With 8 patients the sepsis wasclassified as septic shock with the use of catecholamines. 5 patients had 4 SIRSpoints, 4 had 3 and 2 had 2 points (one was connected to ECMO prior to thetransfer to our hospital). Mean time on ECMO was 35.5 days. Cannulation was inall patients veno-venous and had to be changed in veno-(veno)-arterial in 3patients. 8 patients did not need ECMO after ltx. The mean time on ICU afterltx counted 44.5 days.Conclusion: Infection and even more sepsis are commonly seen as at least relativecontraindications for taking patients on ECMO and bridging them to ltx. Mainreasons are the high mortality rate of septic patients on ECMO and the worseoutcomes after ltx. We were able to show that nearly all patients (11 from 12) couldbe bridged to ltx and the overall mortality rate was relatively low (3 out of12 died). There was no major correlation between high SIRS points, more ECMOdays or use of catecholamines and longer ICU stay or death. Furtherconsideration of the data is needed, in order to identify clues for bestoutcomes in times of scarce resources.