Fiche publication
Date publication
septembre 2013
Auteurs
Membres identifiés du Cancéropôle Est :
Pr FALCOZ Pierre-Emmanuel
Tous les auteurs :
Lafarge M, Mordant P, Thabut G, Brouchet L, Falcoz PE, Haloun A, Le Pimpec-Barthes F, Maury JM, Reynaud-Gaubert M, Saint-Raymond C, Sage E, Stern M, Thomas P, Castier Y, Dorent R, Mal H
Lien Pubmed
Résumé
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation (LTx). However, data concerning this approach remain limited. METHODS: We retrospectively reviewed the medical records of all patients in France who received ECMO as a bridge to LTx from 2007 to 2011. Post-transplant survival and associated factors were assessed by the Kaplan-Meier method and the Cox model. RESULTS: Included were 36 patients from 11 centers. Indications for LTx were cystic fibrosis (CF) in 20 (56%), pulmonary fibrosis (PF) in 11 (30%), and other diagnoses in 5 (14%). ECMO was venovenous for 27 patients (75%) and venoarterial for 9 (25%). Mean follow-up was 17 months. Bridging to LTx was achieved in 30 patients (83%); however, only 27 patients (75%) survived the LTx procedure, and 20 (56%) were discharged from hospital. From ECMO initiation, 2-year survival rates were 50.4% overall, 71.0% for CF patients, 27.3% for PF patients, and 20.0% for other patients (p < 0.001). From LTx, 2-year survival rates were 60.5% overall, 71.0% for CF patients, 42.9% for PF patients, and 33.0% for other patients (p = 0.04). CONCLUSIONS: Our study confirms that the use of ECMO as a bridge to LTx in France could provide a medium-term survival benefit for LTx recipients with critical conditions. Survival differed by underlying respiratory disease. Larger studies are needed to further define the optimal use of ECMO.
Référence
J Heart Lung Transplant. 2013 Sep;32(9):905-13
