Nobuyuki Yoshiyasu1, Masaaki Sato2, Daisuke Nakajima3, Yasuaki Tomioka4, Yui Watanabe5, Takeshi Shiraishi6, Soichiro Funaki7, Sumiko Maeda8, Koichi Tomoshige9, Takahiro Nakajima10, Tomoshi Tsuchiya9, Seiichiro Sugimoto4, Ichiro Yoshino10, Takeshi Nagayasu9, Masayuki Chida8, Masato Minami7, Yoshinori Okada5, Shinichi Toyooka4, Hiroshi Date3, Jun Nakajima1. 1. Department of Thoracic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 2. Department of Thoracic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. satom-sur@h.u-tokyo.ac.jp. 3. Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan. 4. Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 5. Department of Thoracic Surgery, Tohoku University Hospital, Miyagi, Japan. 6. Department of Thoracic, Breast and Endocrine, and Pediatric Surgery, Fukuoka University Hospital, Fukuoka, Japan. 7. Department of General Thoracic Surgery, Osaka University Hospital, Osaka, Japan. 8. Department of General Thoracic Surgery, Dokkyo Medical University Hospital, Tochigi, Japan. 9. Division of Surgical Oncology, Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan. 10. Department of General Thoracic Surgery, Chiba University Hospital, Chiba, Japan.
Abstract
OBJECTIVES: Currently, inhaled nitric oxide (NO) therapy for lung transplantation is not covered by public health insurance in Japan. In this study, we evaluated the perioperative use and safety of inhaled NO therapy for lung transplantation. METHODS: Data regarding the duration of treatment and adverse events of inhaled NO therapy were collected for all lung transplantations performed from January 1, 2015, to December 31, 2019, at nine lung transplant facilities in Japan. RESULTS: During the study period, lung transplants were performed in 357 patients, among whom inhaled NO therapy was administered to 349 patients (98%). The median initial and median maximum inhaled NO doses were 10 and 20 ppm, respectively. Inhaled NO therapy was introduced during surgery and continued postoperatively in 313 patients (90%) for a median of 4 days. Significant improvements in oxygenation and decreases in pulmonary arterial pressure were observed in patients receiving inhaled NO therapy. Side effects of inhaled NO therapy, such as methemoglobinemia, were observed in 15 patients (4%), with a significant incidence in patients aged < 18 years. CONCLUSIONS: Inhaled NO therapy was performed in almost all patients who underwent lung transplantation in Japan and showed reasonable efficacy. Therefore, public health insurance coverage for inhaled NO therapy during lung transplantation is recommended.
OBJECTIVES: Currently, inhaled nitric oxide (NO) therapy for lung transplantation is not covered by public health insurance in Japan. In this study, we evaluated the perioperative use and safety of inhaled NO therapy for lung transplantation. METHODS: Data regarding the duration of treatment and adverse events of inhaled NO therapy were collected for all lung transplantations performed from January 1, 2015, to December 31, 2019, at nine lung transplant facilities in Japan. RESULTS: During the study period, lung transplants were performed in 357 patients, among whom inhaled NO therapy was administered to 349 patients (98%). The median initial and median maximum inhaled NO doses were 10 and 20 ppm, respectively. Inhaled NO therapy was introduced during surgery and continued postoperatively in 313 patients (90%) for a median of 4 days. Significant improvements in oxygenation and decreases in pulmonary arterial pressure were observed in patients receiving inhaled NO therapy. Side effects of inhaled NO therapy, such as methemoglobinemia, were observed in 15 patients (4%), with a significant incidence in patients aged < 18 years. CONCLUSIONS: Inhaled NO therapy was performed in almost all patients who underwent lung transplantation in Japan and showed reasonable efficacy. Therefore, public health insurance coverage for inhaled NO therapy during lung transplantation is recommended.
Entities:
Keywords:
Extracorporeal membrane oxygenation; Health insurance; Lung transplantation; Nitric oxide; Side effect
Authors: Martin Bennett; Clarke Thuys; Simon Augustin; Brad Schultz; Steve Bottrell; Alison Horton; Andrzej Bednarz; Steve Horton Journal: J Extra Corpor Technol Date: 2018-12