The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026
Rethinking paracorporeal lung assist device support in the modern era: Why so different than ECMO?
СтатьяКлинический случайНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Cooper Daniel, Turner Darren, Cooper David S, Hayes Don, Morales David L S
Аннотация
BACKGROUND: Pediatric patients with combined irreversible pulmonary disease and right ventricular (RV) failure on conventional ECMO face significant challenges with rehabilitation and transplant candidacy. We describe our institutional experience with a novel paracorporeal lung assist device (PLAD) configuration as a bridge to lung transplantation.
METHODS: Three pediatric patients with refractory pulmonary hypertension and RV failure were supported with PLAD utilizing an inline pump, left atrial appendage cannulation via a ringed Gore-Tex conduit, and main pulmonary artery cannulation.
RESULTS: All three patients demonstrated substantial clinical improvement on PLAD support. Pulmonary artery pressures decreased significantly, RV function improved, and patients achieved successful physical and nutritional rehabilitation, including independent ambulation. All patients successfully underwent bilateral lung transplantation, with one patient avoiding heart-lung transplantation. Two patients are currently >1 year post-transplant with excellent outcomes.
CONCLUSIONS: PLAD with inline pump support represents an effective bridge to lung transplantation in pediatric patients with combined pulmonary and RV failure. This configuration enables comprehensive cardiac and physical rehabilitation while reducing pulmonary artery pressures, potentially expanding transplant candidacy and improving outcomes.
METHODS: Three pediatric patients with refractory pulmonary hypertension and RV failure were supported with PLAD utilizing an inline pump, left atrial appendage cannulation via a ringed Gore-Tex conduit, and main pulmonary artery cannulation.
RESULTS: All three patients demonstrated substantial clinical improvement on PLAD support. Pulmonary artery pressures decreased significantly, RV function improved, and patients achieved successful physical and nutritional rehabilitation, including independent ambulation. All patients successfully underwent bilateral lung transplantation, with one patient avoiding heart-lung transplantation. Two patients are currently >1 year post-transplant with excellent outcomes.
CONCLUSIONS: PLAD with inline pump support represents an effective bridge to lung transplantation in pediatric patients with combined pulmonary and RV failure. This configuration enables comprehensive cardiac and physical rehabilitation while reducing pulmonary artery pressures, potentially expanding transplant candidacy and improving outcomes.