Abstract
OBJECTIVES: Lung transplantation (LTx) is the only effective treatment for end-stage lung disease. In rapidly deteriorating patients awaiting transplant, supportive strategies for lung function allow only a short period of support and lung transplantation remains the definitive therapy. An urgent transplant programme may reduce the waiting time, allowing lung transplantation in these patients.
METHODS: Since November 2010 a nation-wide urgent lung transplant programme has been established in Italy and patients on the waiting list dependent on mechanical ventilation and/or extracorporeal lung support (ECLS) can be transplanted on an emergency basis with the first available graft in the country. Results of the first 14 months of this programme are analysed here.
RESULTS: From November 2010 to December 2011, 28 patients (14 males, mean age 33.6 ± 14.4 years) were considered for urgent LTx. Rapidly deteriorating lung function was supported with mechanical ventilation alone in 4 patients (14.3%), ECLS in 13 patients (46.4%) and mechanical ventilation plus ECLS in the remaining 11 patients (39.3%). Three patients (10.7%) were excluded because of worsening conditions, 3 patients (10.7%) while on the urgent listed and 22 patients (78.6%) underwent transplantation after 9.8 ± 6.2 days of being on the urgent list. The 30-day mortality rate after LTx was 18%, and the 1-year survival rate was 71.4%.
CONCLUSIONS: The urgent lung transplant programme allowed transplantation in a significant percentage of prioritized patients with acceptable 30-day and 1-year mortality rates. An accurate selection of recipients may further improve the clinical impact of this programme, reducing the ethical concerns about transplantation in high-risk patients.
| Original language | English |
|---|---|
| Pages (from-to) | 795-800 |
| Number of pages | 6 |
| Journal | Interactive Cardiovascular and Thoracic Surgery |
| Volume | 19 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Nov 1 2014 |
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Keywords
- Extracorporeal lung support
- Extracorporeal membrane
- Lung transplantation
- Mechanical ventilation
- Oxygenation
- Urgent lung transplantation
ASJC Scopus subject areas
- Medicine(all)
Cite this
Urgent lung transplant programme in Italy : analysis of the first 14 months. / Boffini, Massimo; Venuta, Federico; Rea, Federico; Colledan, Michele; Santambrogio, Luigi; D'Armini, Andrea M aria; Bertani, Alessandro; Voltolini, Luca; Parisi, Francesco; Marinelli, Giuseppe; Nanni Costa, Alessandro; Rinaldi, Mauro.
In: Interactive Cardiovascular and Thoracic Surgery, Vol. 19, No. 5, 01.11.2014, p. 795-800.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Urgent lung transplant programme in Italy
T2 - analysis of the first 14 months
AU - Boffini, Massimo
AU - Venuta, Federico
AU - Rea, Federico
AU - Colledan, Michele
AU - Santambrogio, Luigi
AU - D'Armini, Andrea M aria
AU - Bertani, Alessandro
AU - Voltolini, Luca
AU - Parisi, Francesco
AU - Marinelli, Giuseppe
AU - Nanni Costa, Alessandro
AU - Rinaldi, Mauro
PY - 2014/11/1
Y1 - 2014/11/1
N2 - OBJECTIVES: Lung transplantation (LTx) is the only effective treatment for end-stage lung disease. In rapidly deteriorating patients awaiting transplant, supportive strategies for lung function allow only a short period of support and lung transplantation remains the definitive therapy. An urgent transplant programme may reduce the waiting time, allowing lung transplantation in these patients.METHODS: Since November 2010 a nation-wide urgent lung transplant programme has been established in Italy and patients on the waiting list dependent on mechanical ventilation and/or extracorporeal lung support (ECLS) can be transplanted on an emergency basis with the first available graft in the country. Results of the first 14 months of this programme are analysed here.RESULTS: From November 2010 to December 2011, 28 patients (14 males, mean age 33.6 ± 14.4 years) were considered for urgent LTx. Rapidly deteriorating lung function was supported with mechanical ventilation alone in 4 patients (14.3%), ECLS in 13 patients (46.4%) and mechanical ventilation plus ECLS in the remaining 11 patients (39.3%). Three patients (10.7%) were excluded because of worsening conditions, 3 patients (10.7%) while on the urgent listed and 22 patients (78.6%) underwent transplantation after 9.8 ± 6.2 days of being on the urgent list. The 30-day mortality rate after LTx was 18%, and the 1-year survival rate was 71.4%.CONCLUSIONS: The urgent lung transplant programme allowed transplantation in a significant percentage of prioritized patients with acceptable 30-day and 1-year mortality rates. An accurate selection of recipients may further improve the clinical impact of this programme, reducing the ethical concerns about transplantation in high-risk patients.
AB - OBJECTIVES: Lung transplantation (LTx) is the only effective treatment for end-stage lung disease. In rapidly deteriorating patients awaiting transplant, supportive strategies for lung function allow only a short period of support and lung transplantation remains the definitive therapy. An urgent transplant programme may reduce the waiting time, allowing lung transplantation in these patients.METHODS: Since November 2010 a nation-wide urgent lung transplant programme has been established in Italy and patients on the waiting list dependent on mechanical ventilation and/or extracorporeal lung support (ECLS) can be transplanted on an emergency basis with the first available graft in the country. Results of the first 14 months of this programme are analysed here.RESULTS: From November 2010 to December 2011, 28 patients (14 males, mean age 33.6 ± 14.4 years) were considered for urgent LTx. Rapidly deteriorating lung function was supported with mechanical ventilation alone in 4 patients (14.3%), ECLS in 13 patients (46.4%) and mechanical ventilation plus ECLS in the remaining 11 patients (39.3%). Three patients (10.7%) were excluded because of worsening conditions, 3 patients (10.7%) while on the urgent listed and 22 patients (78.6%) underwent transplantation after 9.8 ± 6.2 days of being on the urgent list. The 30-day mortality rate after LTx was 18%, and the 1-year survival rate was 71.4%.CONCLUSIONS: The urgent lung transplant programme allowed transplantation in a significant percentage of prioritized patients with acceptable 30-day and 1-year mortality rates. An accurate selection of recipients may further improve the clinical impact of this programme, reducing the ethical concerns about transplantation in high-risk patients.
KW - Extracorporeal lung support
KW - Extracorporeal membrane
KW - Lung transplantation
KW - Mechanical ventilation
KW - Oxygenation
KW - Urgent lung transplantation
UR - http://www.scopus.com/inward/record.url?scp=84925365251&partnerID=8YFLogxK
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U2 - 10.1093/icvts/ivu257
DO - 10.1093/icvts/ivu257
M3 - Article
VL - 19
SP - 795
EP - 800
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
SN - 1569-9293
IS - 5
ER -