{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:48:57Z","timestamp":1790686137554,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,1,8]],"date-time":"2016-01-08T00:00:00Z","timestamp":1452211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The risk\u2013benefit for utilizing cardio\u2010pulmonary bypass (<jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content>) in lung transplantation (<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x) remains debatable. This study compares outcomes after <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x utilizing different <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content> strategies \u2013 elective <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content> vs. off\u2010pump vs. off\u2010pump with unplanned conversion to <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 302 <jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>x performed over seven yr were divided into three groups: \u201coff\u2010pump\u201d group (n = 86), \u201celective on\u2010pump\u201d group (n = 162), and \u201cconversion\u201d group (n = 54). The preoperative donor and recipient demographics and baseline characteristics and the postoperative outcomes were analyzed; 1:1 propensity score matching was used to identify patients operated upon using elective <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content> who had risk profiles similar to those operated upon off\u2010pump (propensity\u2010matching 1) as well as those emergently converted from off\u2010pump to <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content> (propensity\u2010matching 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preoperative group demographic characteristics were comparable; however, the \u201coff\u2010pump\u201d patient group was significantly older. The \u201cconversion\u201d group had a significantly greater number of patients with primary pulmonary hypertension, pulmonary fibrosis, preoperative mechanical ventilation, and preoperative extracorporeal life support (<jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content>). Postoperatively, patients from the \u201cconversion\u201d group had significantly poorer PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> ratios upon arrival in intensive care unit (<jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>) and at 24, 48, and 72 h postoperatively, and they required more prolonged ventilation, longer <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> admission, and they experienced an increased need for <jats:styled-content style=\"fixed-case\">ECLS<\/jats:styled-content> than the other groups. Overall, cumulative survival at one, two, and three yr was significantly worse in patients from the \u201cconversion\u201d group compared to the \u201coff\u2010pump\u201d and \u201celective on\u2010pump\u201d groups \u2013 61.9% vs. 94.4% vs. 86.9%, 54.4% vs. 90.6% vs. 79.5% and 39.8% vs. 78.1% vs. 74.3%, respectively (p &lt; 0.001). The \u201coff\u2010pump\u201d group had significantly better PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> ratios, and a significantly shorter duration of ventilation, <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> stay, and hospital length of stay when compared to the propensity\u2010matched \u201celective on\u2010pump\u201d group. There were no statistically significant differences in postoperative outcomes and overall survival between the \u201cconverted\u201d group and the propensity\u2010matched \u201celective on\u2010pump\u201d group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite segregation of unplanned <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content> conversion cases from elective on\u2010pump cases, patients with comparable preoperative demographic\/risk profiles demonstrated better early postoperative outcomes and, possibly, an improved early survival with an off\u2010pump strategy. A considerable proportion of high\u2010risk patients require intraoperative conversion from off\u2010pump to <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content>, and this seems associated with suboptimal outcomes; however, there is no significant benefit to employing an elective on\u2010pump strategy over emergent conversion in the high\u2010risk group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12674","type":"journal-article","created":{"date-parts":[[2015,12,12]],"date-time":"2015-12-12T15:08:32Z","timestamp":1449932912000},"page":"202-209","source":"Crossref","is-referenced-by-count":39,"title":["The role of cardiopulmonary bypass in lung transplantation"],"prefix":"10.1111","volume":"30","author":[{"given":"Prashant N.","family":"Mohite","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Sabashnikov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil P.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Garcia\u2010Saez","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartlomeij","family":"Zych","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Zeriouh","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalba","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Soresi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Carby","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"De Robertis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toufan","family":"Bahrami","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Amrani","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandor","family":"Marczin","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre R.","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron\u2010Frederik","family":"Popov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation &amp; Mechanical Circulatory Support Royal Brompton &amp; Harefield NHS Foundation Trust Harefield Hospital Harefield Middlesex UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,1,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.06.003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSMBR.894020"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSMBR.893674"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904083401406"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2005.03.004"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(93)91048-R"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092773"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201210-1865OC"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)90573-8"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70396-4"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)01425-9"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200409-1243OC"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.03.003"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSMBR.895419"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)91367-6"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)91135-V"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.05.012"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu383"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv051"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fctr.12674","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.12674","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:03:12Z","timestamp":1695567792000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.12674"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,8]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1111\/ctr.12674"],"URL":"https:\/\/doi.org\/10.1111\/ctr.12674","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,8]]}}}