BACKGROUND: Long-term mechanical ventilation is considered as a relative or absolute contraindication for lung transplantation by most centers. We report on the results of transplantation in nine patients requiring long-term mechanical ventilation at two lung transplant centers. METHODS: The study group (group 1) consisted of nine patients receiving mechanical ventilation who underwent lung transplantation at either Duke University Medical Center or the University of Florida between 1992 and 1997. Patients in group 1 met the following criteria: they underwent exercise therapy with a physical therapist, and they were without panresistant bacterial airway colonization. The study patients that met these criteria spent at least 13 days receiving mechanical ventilation prior to transplantation. The control population (group 2; n = 65) consisted of all patients who underwent transplantation at either center in the calendar year 1997 who were ventilator independent. The 1-year survival rates in each group were calculated by the Kaplan-Meier method. The number of days required for extubation in each group were compared by the nonparametric Wilcoxon rank sum test. The FEV(1) value at 1 year was reported in each group. RESULTS: The 1-year survival rates were 78% and 83% in group 1 and group 2, respectively. The mean number of days required until extubation were 41 days in group 1 and 9 days in group 2 (p < 0.01). The allograft function was comparable in the two groups at 1 year. CONCLUSIONS: In a select population of ventilator-dependent patients, the 1-year survival rate is comparable to the standard lung transplant population. However, these ventilator-dependent patients require a significantly longer time until extubation than other transplant recipients.
BACKGROUND: Long-term mechanical ventilation is considered as a relative or absolute contraindication for lung transplantation by most centers. We report on the results of transplantation in nine patients requiring long-term mechanical ventilation at two lung transplant centers. METHODS: The study group (group 1) consisted of nine patients receiving mechanical ventilation who underwent lung transplantation at either Duke University Medical Center or the University of Florida between 1992 and 1997. Patients in group 1 met the following criteria: they underwent exercise therapy with a physical therapist, and they were without panresistant bacterial airway colonization. The study patients that met these criteria spent at least 13 days receiving mechanical ventilation prior to transplantation. The control population (group 2; n = 65) consisted of all patients who underwent transplantation at either center in the calendar year 1997 who were ventilator independent. The 1-year survival rates in each group were calculated by the Kaplan-Meier method. The number of days required for extubation in each group were compared by the nonparametric Wilcoxon rank sum test. The FEV(1) value at 1 year was reported in each group. RESULTS: The 1-year survival rates were 78% and 83% in group 1 and group 2, respectively. The mean number of days required until extubation were 41 days in group 1 and 9 days in group 2 (p < 0.01). The allograft function was comparable in the two groups at 1 year. CONCLUSIONS: In a select population of ventilator-dependent patients, the 1-year survival rate is comparable to the standard lung transplant population. However, these ventilator-dependent patients require a significantly longer time until extubation than other transplant recipients.
Authors: Jens Gottlieb; Gregor Warnecke; Johannes Hadem; Martin Dierich; Olaf Wiesner; Thomas Fühner; Martin Strueber; Axel Haverich; Tobias Welte Journal: Intensive Care Med Date: 2012-04-14 Impact factor: 17.440
Authors: J P Singer; P D Blanc; C Hoopes; J A Golden; J L Koff; L E Leard; S Cheng; H Chen Journal: Am J Transplant Date: 2011-08-10 Impact factor: 8.086
Authors: Kyle J Rehder; David A Turner; Matthew G Hartwig; W Lee Williford; Desiree Bonadonna; Richard J Walczak; R Duane Davis; David Zaas; Ira M Cheifetz Journal: Respir Care Date: 2012-12-04 Impact factor: 2.258
Authors: Timothy J George; Claude A Beaty; Arman Kilic; Pali D Shah; Christian A Merlo; Ashish S Shah Journal: J Heart Lung Transplant Date: 2012-08-11 Impact factor: 10.247