ECMO vs. Cardiopulmonary Bypass in Lung Transplantation

link.springer.com December 24, 2024

Extracorporeal membrane oxygenation (ECMO) offers perioperative advantages in lung transplantation, reducing postoperative complications, one-year mortality, and recovery time compared to CPB. However, the longer total ischemic time with ECMO warrants further investigation into its long-term outcomes.

We searched PubMed, Embase, and Cochrane databases for studies comparing ECMO to CPB in lung transplantation.

Odds ratios (ORs) for binary endpoints and mean differences (MDs) for continuous outcomes were calculated with 95% confidence intervals (CIs).

DerSimonian and Laird random-effects model was applied for all endpoints. I2 statistics was used to assess heterogeneity.

Fourteen studies with a total of 1797 patients were included. ECMO was associated with significant reductions in hepatic dysfunction (OR 0.47, 95% CI 0.25–0.90), hemodialysis (OR 0.62, 95% CI 0.43–0.88), severe graft rejection (OR 0.43, 95% CI 0.23–0.78), one-year mortality (OR 0.70; 95% CI 0.51 to 0.98; p = 0.04; I2 = 13%) and tracheostomy rates (OR 0.62, 95% CI 0.46–0.86).