Table 1 Study characteristics
First author | Year | Country | Type of study | Inclusion criteria | Exclusion criteria | Principal outcome | Overall population (N) | Age (mean) | M (n, %) |
|---|---|---|---|---|---|---|---|---|---|
Aigner | 2007 | Austria | Retrospective observational study | Patients performing LTx | Not declared | To summarize experience with ECMO in the field of LT | 306 (ECMOd: 130; ECMOr: 112; off-pump: 149) | 45.63 | 174 56.8% |
Bermudez | 2014 | USA | Cohort study | Patients performing double LTx with intraoperatively ECLS | Not declared | To compare the early outcomes of LTx using CPB or VA-ECMO | 645 (ECMOd:49; CPB: 222; off-pump: 374) | 56.96 | 372 57.67% |
Biscotti | 2014 | USA | Cohort study | Patients performing double LTx with ECLS | Not declared | To compare outcomes and operative parameters VA-ECMO versus CPB in LTx patients | 102 (ECMOd: 47; CPB: 55) | 48.69 | 52 50% |
Bittner | 2007 | Germany | Cohort study | Patients performing double LTx | Multiorgan transplantation; | To report the experiences of replacing CPB with VA-ECMO support in LTx | 15 (ECMOd: 8; CPB: 7) | NA | NA |
Calabrese | 2022 | Italy | Retrospective observational study | Patients performing double LTx | Volumetric reductions in the graft; re- or multiorgan transplantation; ex vivo perfusion; bridge with ECMO to LTx | To assess ischemia in lung tissue from LTx patients receiving intraoperative VA-ECMO support and non-ECMO support | 51 (ECMOd: 13; off-pump: 38) | 52 | 17 33.3% |
Chacon-Alberty | 2022 | USA | Cohort study | Patients performing LTx | Missing biomarker values; multiorgan transplantation; | To compare the postreperfusion circulatory cytokine patterns associated with LTx performed off-pump or with the use of CPB or VA-ECMO | 59 (ECMOd:15; off-pump:26) | 49.17 | 38 64.4% |
Chan | 2023 | USA | Cohort study | Patients performing LTx using (i) no ECLS, (ii) VA-ECMO, and (iii) CPB | LTx on VV-ECMO, bridge with ECMO, single or re-LTx, multiorgan transplantation, or cardiac procedures | To compare outcomes of intraoperative VA-ECMO and CPB during BLTx with a propensity analysis | 557 (ECMOd:150; CPB: 197; off-pump: 210) | 59 | 320 57% |
Cosgun | 2017 | Swiss | Cohort study | Patients performing LTx | Not declared | To investigate the outcome and risk factors on survival in recipients undergoing LTx with intraoperative ECMO support | 291 (ECMOd: 134; off-pump: 157) | 46.85 | 157 53.9% |
Coster | 2023 | USA | Cohort study | Patients performing double LTx | Re- or multiorgan transplantation; intraoperative veno-venous ECMO, ex vivo lung perfusion | To investigate clinical outcomes of LTx in association with biomarkers of endothelial injury in conjunction with various ECLS strategies | 55 (ECMOd: 22; CPB: 20; off-pump:13) | 32 | 25 45.4% |
Dalibon | 2006 | France | Cohort study | Patients performing double LTx | Not declared | To report the experience of planned and unplanned use of CPB for LTx | 140 (CPB: 23; off-pump: 117) | 41 | 92 65.7% |
Dell’Amore | 2020 | Italy | Cohort study | Patients receiving double LTx for pulmonary hypertension | Absence of pulmonary hypertension | To review the results of ECLS strategy during and after BLTx for pulmonary artery hypertension | 38 (ECMOd: 21; CPB: 17) | 39 | 16 42.1% |
Erkılınç | 2023 | Turkey | Cohort study | Patients performing double LT | ECMO as a bridge to LTx | To review experience with patients who underwent LTx with or without ECMO | 48 (ECMOd: 29; off-pump: 19) | 50.28 | 34 70.8% |
Fessler | 2020 | France | Cohort study | Patients performing double LTx | ECMO bridge, multiorgan transplantation, re-transplantation, CPB | To assess prognoses of patients undergoing unplanned-intraoperative VA-ECMO | 300 (ECMOd: 14; ECMOr: 77; off-pump: 209) | 50.58 | 165 55% |
Gammie | 1998 | USA | Cohort study | Patients performing double LTx | ECLS before LTx; Eisenmenger’s syndrome; over-sized double-lung graft | To assess the effect of CPB on allograft function and recipient survival in DLTx | 94 (CPB: 37; off-pump:57) | NA | NA |
Halpern | 2022 | USA | Cohort study | Patients with no or mild pulmonary hypertension performing isolated BLTx with planned off-pump or VA-ECMO | Multiorgan or single LT, moderate or severe PH, concomitant cardiac surgery, intraoperative support strategies other than off-pump or VA ECMO | To compare rates of textbook outcome between BOLTs performed with planned VA ECMO or off-pump support | 237 (ECMOd:68; off-pump: 169) | 61 | 129 54.4% |
Hlozek | 1997 | USA | Cohort study | Single or double LTx performed with CPB support or with off-pump method | Not declared | To clarify the effect of CPB on LTx recipients | 70 (CPB: 30; off-pump: 40) | NA | NA |
Hoechter | 2015 | Germany | Cohort study | Patients performing double LTx with intraoperatively ECLS | Bridge-to-transplant ECMO therapy | To analyze transfusion requirements, coagulation parameters, and outcome parameters LTx recipients comparing CPB and ECMO | 47 (ECMOd: 26; CPB: 21) | NA | NA |
Hoetzenecker | 2018 | Austria | Cohort study | Patients performing double LTx | Single-LTx, re-transplantations, heart–LTx, bridged to transplantation | To review the results of ECMO use in LTx | 582 (ECMOd: 466; off-pump: 116) | 45.5 | 147 25.2% |
Ius | 2012 | Germany | Cohort study | Patients performing double LTx with intraoperatively ECLS | Patients performing LTx before start of the study | To compare the postoperative course and outcomes of LTx patients treated using VA-ECMO or CPB | 92 (ECMOd: 46; CPB: 46) | 42.69 | 48 52.17% |
Ius | 2020 | Germany | Cohort study | Patients undergoing isolated LTx with or without ECMO support | CPB use | To present the experience using intraoperative ECMO in isolated LTx evaluating its impact on long-term graft function and survival | 1137 (ECMOd: 311; off-pump: 826) | 51.9 | 593 52.15% |
Loor | 2022 | USA, Europe | Cohort study | Patients performing double LTx | Multiorgan transplantation | To clarify the relationship between the use of ECLS during LTx and severe PGD | 852 (ECMOd: 273; CPB: 157; off-pump: 422) | 54.29 | 472 55.39% |
Machuca | 2015 | Canada | Cohort study | Patients performing double LTx with intraoperatively ECLS | Bridge with ECLS, concomitant cardiac procedure, multiorgan transplant, colonization with Burkholderia cenocepacia, emergency ECLS | To compare the outcomes of intraoperative ECMO versus CPB in LTx | 99 (ECMOd: 33; CPB: 66) | 43.73 | 49 49.5% |
Pettenuzzo | 2018 | Italy | Cohort study | Patients performing double LTx | Bridge to LTx with ECMO and/or preoperative MV | To evaluate the association of the intraoperative use of ECMO for LTx with blood products transfusion, short-term and mid-term postoperative complications | 52 (ECMOd: 15; off-pump: 37) | 50.73 | 36 69.23% |
Ruszel | 2021 | Poland | Cohort study | Patients performing LTx | Not declared | To analyze the survival rates and frequency of complications in LTx according use of intraoperative ECMO versus CPB | 63 (ECMOd: 14; CPB: 8; off-pump:37) | 47.23 | 33 52.38% |
Scaravilli | 2020 | Italy | Cohort study | CF patients who underwent LTx | Single LTx; re-transplantation; missing medical records | To find risk factors at the time of enlistment associated with the intraoperative use of ECLS and to compare the outcomes of CF patients treated with ECLS during LTx or not | 70 (ECMOd:28; off-pump: 42) | 28.2 | 36 51.4% |
Szeto | 2022 | USA | Cohort study | COPD patients who underwent to double LTx | Not declared | To determine whether CPB has deleterious effects on lung function or clinical outcome | 50 (CPB: 14; off-pump: 36) | 50.99 | 31 62% |
Zhao | 2022 | China | Cohort study | Patients performing LTx | Not declared | To review the clinical outcomes and complications of LTx recipients who received ECMO support both intra- and postoperatively in a single center | 86 (ECMOd: 32; off-pump: 54) | 63 | 22 25.6% |