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New perspectives in ECMO 2012 ECMO and lung transplant program. Franco Valenza Department of Pathophysiology and Transplantation Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico. New perspectives in ECMO 2012 ECMO and lung transplant program. No conflict of interest.
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New perspectives in ECMO 2012 ECMO and lung transplant program Franco Valenza Department of Pathophysiology and Transplantation Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
New perspectives in ECMO 2012 ECMO and lung transplant program No conflict of interest
New perspectives in ECMO 2012 ECMO and lung transplant program Conventional Un-conventional
Conventional ECMO - PGD ECMO - Support ECMO - Bridge
Lung Transplantation before during after ECMO - PGD ECMO - Support ECMO - Bridge
Anticoagulation Hemodynamics Hypoxia - Hypercapnia ECMO - PGD ECMO - Support ECMO - Bridge
ECMO - PGD ECMO - Support ECMO - Bridge
ECMO Bridge Lung Transplantation Pub Medsearch Lang, Transplantation (2012);93:729 Bittner, Ann Thor Surg (2012);94:942
ECMO Bridge Lung Transplantation Pub Medsearch Awake vs.Intubated Ambulatory ECMO bridge Early vs. Late
ECMO - PGD ECMO - Support ECMO - Bridge
Postoperative “treatment” tool Oto, Ann Thor Surg (2004);78:1230
Intraoperative “prevention” tool Low perfusion pressure Bhabra, Ann Thor Surg 1996;61:1631 Bhabra, Ann Thor Surg 1998;65:187 Pierre, J Thorac Cardiovasc Surg 1998;116:932 Clark, J Thorac Cardiovasc Surg 1998;115:1335 Halldorsson, J Thorac Cardiovasc Surg 1998;115:415 Protective ventilation De Perrot, J Thorac Cardiovasc Surg 2002;124:1137 Crimi, Am J respir Crit Care Med 2005;174:178 Chiang, Resuscitation 2008;79:147 Valenza, Organ Tissue & Cells (2012)
MCP-1 CXCL-10 * Control BD Ischemia Graft Relative expression IL-8 HMGB-1 * * * Control BD Ischemia Graft Control BD Ischemia Graft Control BD Ischemia Graft Valenza, un published
New perspectives in ECMO 2012 ECMO and lung transplant program Conventional Un-conventional
ECMO - PGD ECMO - Support ECMO - Bridge RECIPIENT
LUNG DONOR reverse - ECMO ECMO - PGD ECMO - Support ECMO - Bridge RECIPIENT
reverse - ECMO Ex-Vivo Lung Perfusion (EVLP)
* Valenza, Transpl Proc (2012); 44:1826-9
LUNG DONOR donor - ECMO reverse - ECMO ECMO - PGD ECMO - Support ECMO - Bridge RECIPIENT
Maastricht VI Refractory cardiogenic shock ECMO Liver OLTX LUNG DONOR BRAIN DEATH CARDIAC DEATH Rat Lungs Maastricht III Lung Harvest Maastricht II EVLP ECMO Transplantation
…. in conclusion No way I’m gonna stay with-out ECMO! Bridge Support PGD RECIPIENT EVLP DCD LUNG DONOR