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Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO

Severe respiratory failure caused by COVID-19 often requires mechanical ventilation, including extracorporeal membrane oxygenation (ECMO). In rare cases, lung transplantation (LTx) may be considered as a last resort. However, uncertainties remain about patient selection and optimal timing for referr...

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Autores principales: Levy, Liran, Deri, Ofir, Huszti, Ella, Nachum, Eyal, Ledot, Stephane, Shimoni, Nir, Saute, Milton, Sternik, Leonid, Kremer, Ran, Kassif, Yigal, Zeitlin, Nona, Frogel, Jonathan, Lambrikov, Ilya, Matskovski, Ilia, Chatterji, Sumit, Seluk, Lior, Furie, Nadav, Shafran, Inbal, Mass, Ronen, Onn, Amir, Raanani, Ehud, Grinberg, Amir, Levy, Yuval, Afek, Arnon, Kreiss, Yitshak, Kogan, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299376/
https://www.ncbi.nlm.nih.gov/pubmed/37373734
http://dx.doi.org/10.3390/jcm12124041
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author Levy, Liran
Deri, Ofir
Huszti, Ella
Nachum, Eyal
Ledot, Stephane
Shimoni, Nir
Saute, Milton
Sternik, Leonid
Kremer, Ran
Kassif, Yigal
Zeitlin, Nona
Frogel, Jonathan
Lambrikov, Ilya
Matskovski, Ilia
Chatterji, Sumit
Seluk, Lior
Furie, Nadav
Shafran, Inbal
Mass, Ronen
Onn, Amir
Raanani, Ehud
Grinberg, Amir
Levy, Yuval
Afek, Arnon
Kreiss, Yitshak
Kogan, Alexander
author_facet Levy, Liran
Deri, Ofir
Huszti, Ella
Nachum, Eyal
Ledot, Stephane
Shimoni, Nir
Saute, Milton
Sternik, Leonid
Kremer, Ran
Kassif, Yigal
Zeitlin, Nona
Frogel, Jonathan
Lambrikov, Ilya
Matskovski, Ilia
Chatterji, Sumit
Seluk, Lior
Furie, Nadav
Shafran, Inbal
Mass, Ronen
Onn, Amir
Raanani, Ehud
Grinberg, Amir
Levy, Yuval
Afek, Arnon
Kreiss, Yitshak
Kogan, Alexander
author_sort Levy, Liran
collection PubMed
description Severe respiratory failure caused by COVID-19 often requires mechanical ventilation, including extracorporeal membrane oxygenation (ECMO). In rare cases, lung transplantation (LTx) may be considered as a last resort. However, uncertainties remain about patient selection and optimal timing for referral and listing. This retrospective study analyzed patients with severe COVID-19 who were supported by veno-venous ECMO and listed for LTx between July 2020 and June 2022. Out of the 20 patients in the study population, four who underwent LTx were excluded. The clinical characteristics of the remaining 16 patients were compared, including nine who recovered and seven who died while awaiting LTx. The median duration from hospitalization to listing was 85.5 days, and the median duration on the waitlist was 25.5 days. Younger age was significantly associated with a higher likelihood of recovery without LTx after a median of 59 days on ECMO, compared to those who died at a median of 99 days. In patients with severe COVID-19-induced lung damage supported by ECMO, referral to LTx should be delayed for 8–10 weeks after ECMO initiation, particularly for younger patients who have a higher probability of spontaneous recovery and may not require LTx.
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spelling pubmed-102993762023-06-28 Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO Levy, Liran Deri, Ofir Huszti, Ella Nachum, Eyal Ledot, Stephane Shimoni, Nir Saute, Milton Sternik, Leonid Kremer, Ran Kassif, Yigal Zeitlin, Nona Frogel, Jonathan Lambrikov, Ilya Matskovski, Ilia Chatterji, Sumit Seluk, Lior Furie, Nadav Shafran, Inbal Mass, Ronen Onn, Amir Raanani, Ehud Grinberg, Amir Levy, Yuval Afek, Arnon Kreiss, Yitshak Kogan, Alexander J Clin Med Brief Report Severe respiratory failure caused by COVID-19 often requires mechanical ventilation, including extracorporeal membrane oxygenation (ECMO). In rare cases, lung transplantation (LTx) may be considered as a last resort. However, uncertainties remain about patient selection and optimal timing for referral and listing. This retrospective study analyzed patients with severe COVID-19 who were supported by veno-venous ECMO and listed for LTx between July 2020 and June 2022. Out of the 20 patients in the study population, four who underwent LTx were excluded. The clinical characteristics of the remaining 16 patients were compared, including nine who recovered and seven who died while awaiting LTx. The median duration from hospitalization to listing was 85.5 days, and the median duration on the waitlist was 25.5 days. Younger age was significantly associated with a higher likelihood of recovery without LTx after a median of 59 days on ECMO, compared to those who died at a median of 99 days. In patients with severe COVID-19-induced lung damage supported by ECMO, referral to LTx should be delayed for 8–10 weeks after ECMO initiation, particularly for younger patients who have a higher probability of spontaneous recovery and may not require LTx. MDPI 2023-06-14 /pmc/articles/PMC10299376/ /pubmed/37373734 http://dx.doi.org/10.3390/jcm12124041 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Levy, Liran
Deri, Ofir
Huszti, Ella
Nachum, Eyal
Ledot, Stephane
Shimoni, Nir
Saute, Milton
Sternik, Leonid
Kremer, Ran
Kassif, Yigal
Zeitlin, Nona
Frogel, Jonathan
Lambrikov, Ilya
Matskovski, Ilia
Chatterji, Sumit
Seluk, Lior
Furie, Nadav
Shafran, Inbal
Mass, Ronen
Onn, Amir
Raanani, Ehud
Grinberg, Amir
Levy, Yuval
Afek, Arnon
Kreiss, Yitshak
Kogan, Alexander
Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
title Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
title_full Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
title_fullStr Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
title_full_unstemmed Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
title_short Timing of Lung Transplant Referral in Patients with Severe COVID-19 Lung Injury Supported by ECMO
title_sort timing of lung transplant referral in patients with severe covid-19 lung injury supported by ecmo
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299376/
https://www.ncbi.nlm.nih.gov/pubmed/37373734
http://dx.doi.org/10.3390/jcm12124041
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