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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1512742
This article is part of the Research Topic Emerging Techniques in Graft Preservation: Machine Perfusion and Therapeutic Interventions - Volume II View all articles
The Comparative Impact of Central vs. Peripheral VA-ECMO Cannulation on Postoperative Graft Dysfunction in Lung Transplantation: A Retrospective Analysis
Provisionally accepted- 1 Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu Province, China
- 2 Duke University, Durham, United States
Background: Lung transplantation (LTx) is the definitive treatment for end-stage pulmonary diseases, with venoarterial extracorporeal membrane oxygenation (VA-ECMO) used as a common perioperative support. However, it remains unclear if central (cVA-ECMO) or peripheral (pVA-ECMO) cannulation routes yield better outcomes in postoperative prognosis. This study compares the impact of these two cannulation strategies on primary graft dysfunction (PGD) incidence in LTx patients.: A retrospective analysis was performed on 153 LTx patients supported with VA-ECMO at the Wuxi Lung Transplant Center (January 2019-March 2023). Patients were divided into central (n = 31) and peripheral (n = 91) groups. Data included recipient/donor demographics, preoperative status, and follow-up outcomes. The primary outcome was PGD within 72 h after reperfusion, whereas secondary outcomes included in-hospital mortality, 1-year survival, renal support needs, ventilation duration, intensive care unit (ICU) stay, and biochemical markers.Results: PGD incidence was significantly higher in the peripheral group, with longer ECMO duration, ventilation, and ICU stay. Central VA-ECMO showed advantages in inhospital mortality and 1-year survival rates.Central VA-ECMO cannulation may reduce postoperative complications and improve survival for LTx recipients. Prospective studies are needed to confirm these findings and refine perioperative ECMO management.
Keywords: Lung Transplantation, Anesthesia, Retrospective study, Extracorporeal Membrane Oxygenation, Primary Graft Dysfunction, Survival Rate
Received: 17 Oct 2024; Accepted: 12 Feb 2025.
Copyright: © 2025 Wu, Miao, Zhou, Wu, Chen, Wang and ZHANG. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Guilong Wang, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, 211166, Jiangsu Province, China
XIN ZHANG, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, 211166, Jiangsu Province, China
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