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Canadian Respiratory Journal
Volume 2017 (2017), Article ID 5947978, 5 pages
https://doi.org/10.1155/2017/5947978
Research Article

Mechanical Circulatory Support as a Bridge to Lung Transplantation: A Single Canadian Institution Review

1Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
2Department of Surgery, Division of Cardiac Surgery, Edmonton, AB, Canada
3Department of Medicine, University of Alberta, Edmonton, AB, Canada
4Human Organ Procurement and Exchange Program, Edmonton, AB, Canada
5Canadian National Transplant Research Program, Edmonton, AB, Canada
6Alberta Transplant Institute, Edmonton, AB, Canada

Correspondence should be addressed to Jayan Nagendran; ac.atreblau@nayaj

Received 1 May 2017; Accepted 2 August 2017; Published 29 August 2017

Academic Editor: Antoni Torres

Copyright © 2017 Katie Kinaschuk et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Lung transplant (LTx) waitlists continue to grow internationally. Consequently, more patients are progressing to require mechanical circulatory support (MCS) as a bridge to transplantation (BTT). MCS strategies include interventional lung assist (iLA) and venovenous (VV) and venoarterial (VA) extracorporeal membrane oxygenation (ECMO). We review our series of patients bridged with MCS while listed for LTx. Methods. All consecutive patients, listed for LTx requiring MCS as a BTT at the University of Alberta from 2004 to 2015, were included. Patient demographics and outcomes were compared for the 3 groups (iLA, VV-ECMO, and VA-ECMO). Results. Of the 24 patients supported with MCS devices, 17 were successfully transplanted and 7 died waiting. In total, 25% () were bridged with VA-ECMO, 54% () with VV-ECMO, and 21% () with iLA. Overall, 71% of patients were bridged successfully to LTx. The 1-year survival posttransplantation was 88%. Conclusion. We have demonstrated the feasibility of utilizing the MCS modalities of VA-ECMO, VV-ECMO, and most recently iLA, as a BTT. MCS is a viable strategy for BTT, offering improved survival outcomes for decompensating adult patients awaiting LTx, resulting in excellent survival posttransplantation.