Outcomes after lung transplantation performed using elective cardiopulmonary bypass: A single-center experience
Walker M. Blanding, MD,
Morgan A. Hill, MD,
Z.A. Hashmi, MD,
Kevin X. Huang, MD,
Timothy P.M. Whelan, MD,
Luca Paoletti, MD,
Kathryn E. Engelhardt, MD, MS,
Barry C. Gibney, DO
Affiliations
Walker M. Blanding, MD
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
Morgan A. Hill, MD
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
Z.A. Hashmi, MD
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
Kevin X. Huang, MD
Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
Timothy P.M. Whelan, MD
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
Luca Paoletti, MD
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
Kathryn E. Engelhardt, MD, MS
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
Barry C. Gibney, DO
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina; Corresponding author: Barry C. Gibney, DO, Division of Cardiothoracic Surgery, Medical University of South Carolina, 30 Courtney Drive, Charleston, SC 29425.
Background: There remains significant variability in the use of intraoperative mechanical circulatory support in lung transplantation. This report details our outcomes using elective cardiopulmonary bypass (CPB) in lung transplantation. Methods: We performed a single institution analysis of consecutively enrolled patients who underwent isolated lung transplantation between August 2020 and April 2023. Primary outcomes included rates of grade 3 primary graft dysfunction (PGD) and 1-year survival. Results: Forty consecutive lung transplants were performed on CBP over the study period. The average PaO2/FiO2 at 72 hours was 369.7 ± 121.4, with grade 3 PGD occurring in 2 patients (5%). The median intraoperative packed red blood cell transfusion requirement was 300 (93.75-727.5) ml. Freedom from nonelective reoperation was 82.5% (n = 33). Mortality was 0% at 90 days, and 1-year survival was 90.5%. Conclusions: Lung transplantation can be safely performed with elective CPB support.
