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One-Year Experience With High-Emergency Lung Transplantation in France.
MedLine Citation:
PMID:  22531492     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The continuing significant number of patients who die while on a waiting list for lung transplantation (LTx) has led several countries to modify their lung allocation rules in recent years. France has implemented high-emergency allocation rules to allow patients at imminent risk of death to undergo priority transplantation within several days. The aim of this study was to report on the early (2-year) experience of high-emergency LTx (HELTx) in France. METHODS: From July 1, 2007, to June 30, 2008, 186 patients underwent LTx in France in nine centers. Among them, 32 patients (17.2%) underwent HELTx (19 with cystic fibrosis, 7 pulmonary fibrosis, and 6 other diagnoses). The reasons for HELTx were risk of invasive mechanical ventilation (n=20), invasive mechanical ventilation (n=8), and extracorporeal membrane oxygenation (n=4). RESULTS: The median time between being placed on the HELTx waiting list and LTx was 3 days (interquartile range: 1-8 days). Survival rates in the HELTx group were 90.5%, 71%, 64.5%, 55%, and 51.5% at 1, 3, 6, 12, and 24 months, respectively, which were significantly lower than for 154 patients who underwent regular, nonurgent LTx during the study period (88.5%, 83%, 79%, 77%, and 71%, respectively). CONCLUSIONS: Our data demonstrate that the new LTx allocation rules implemented in France since 2007 allow for rapid organ procurement for patients at imminent high risk of death. HELTx is feasible but yields poorer survival than elective LTx. Further studies are needed to assess implications of this organ allocation policy on the long run.
Authors:
Veronique Boussaud; Hervé Mal; Ludovic Trinquart; Gabriel Thabut; Isabelle Danner-Boucher; Claire Dromer; Christelle Saint Raymond; Martine Reynaud-Gaubert; Romain Kessler; Francois Philit; Richard Dorent; Marc Stern
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-22
Journal Detail:
Title:  Transplantation     Volume:  -     ISSN:  1534-6080     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Service de chirurgie cardiaque, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France. 2 Service de pneumologie, Hôpital Bichat, Paris, Assistance Publique Hôpitaux de Paris, Université Denis Diderot, Paris, France. 3 Département d'épidémiologie, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France. 4 Service de pneumologie, CHU Nantes, France. 5 Service de chirurgie thoracique, hôpital Haut Levêque, Pessac, France. 6 Département de pneumologie, Hôpital de la Tronche, Grenoble, France. 7 Département de pneumologie, Hôpital Sainte Marguerite, Marseille, France. 8 Service de pneumologie, Hôpital Hautepierre, Strasbourg, France. 9 Service de pneumologie, Hôpital Louis Pradel, Lyon, France. 10 Agence de la Biomédecine, Paris, France. 11 Service de pneumologie, Hôpital Foch, Suresnes, Paris, France.
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