Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1785064348608102400 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10299376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT levyliran timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT deriofir timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT husztiella timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT nachumeyal timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT ledotstephane timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT shimoninir timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT sautemilton timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT sternikleonid timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT kremerran timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT kassifyigal timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT zeitlinnona timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT frogeljonathan timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT lambrikovilya timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT matskovskiilia timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT chatterjisumit timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT seluklior timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT furienadav timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT shafraninbal timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT massronen timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT onnamir timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT raananiehud timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT grinbergamir timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT levyyuval timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT afekarnon timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT kreissyitshak timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo AT koganalexander timingoflungtransplantreferralinpatientswithseverecovid19lunginjurysupportedbyecmo |