{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:47:23Z","timestamp":1787856443048,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early utilization of extracorporeal membrane oxygenation (ECMO) improves the clinical outcomes of patients with severe primary graft dysfunction (PGD3) after lung transplantation. Although there is a survival benefit, the impact of ECMO on airway complications has not been investigated. This study aims to describe the clinical association between posttransplant methods of support and the severity of acute airway anastomosis complications in patients with PGD3 following bilateral lung transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from adult bilateral lung transplant patients diagnosed with PGD3 at our institution were retrospectively reviewed. Bronchial anastomosis necrosis (ischemia reperfusion injury [IRI]) that developed within a month after transplantation was graded. The data were compared among the groups of veno\u2010venous ECMO (VV\u2010ECMO) (<jats:italic>n<\/jats:italic> = 77), veno\u2010arterial ECMO (VA\u2010ECMO) (<jats:italic>n<\/jats:italic> = 14), and mechanical ventilation (MV, <jats:italic>n<\/jats:italic> = 33).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher levels of support (VV\/VA\u2010ECMO) were associated with a lower incidence of PGD3, which was highest in recipients on MV only (<jats:italic>M<\/jats:italic><jats:sup>2<\/jats:sup> = 19.54, <jats:italic>r<\/jats:italic> = \u22120.41, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In a multivariable competing risk analysis, VV\u2010ECMO was protective against chronic allograft dysfunction (CLAD) relative to the MV group (HR: 0.36 [0.13\u20130.96], <jats:italic>p<\/jats:italic> = 0.042). There was no relationship between posttransplant support and survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests posttransplant VV\u2010ECMO support in patients who develop PGD3 may confer a protective advantage over MV alone in the prevention of ischemic reperfusion injury. VV\u2010ECMO was associated with lower IRI grades and lower rates of BOS after transplantation. Future studies investigating the causal mechanisms are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70029","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T06:14:59Z","timestamp":1731996899000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Veno\u2010Venous Extracorporeal Membrane Oxygenation Support for Severe Primary Graft Dysfunction Is Associated With Reduced Airway Complications After Lung Transplantation"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8921-1944","authenticated-orcid":false,"given":"Kentaro","family":"Noda","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed\u2010Ali H.","family":"Jawad\u2010Makki","sequence":"additional","affiliation":[{"name":"School of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest G.","family":"Chan","sequence":"additional","affiliation":[{"name":"Section of Thoracic Surgery Department of Surgery University of Chicago Biological Sciences Division  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8102-9072","authenticated-orcid":false,"given":"Masashi","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadi A.","family":"Hage","sequence":"additional","affiliation":[{"name":"School of Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Division of Pulmonary Medicine Allergy and Critical Care University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo G.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Section of Thoracic Surgery Department of Surgery University of Chicago Biological Sciences Division  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.08.013"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200409-1243OC"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000232"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.07.021"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.04.019"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.16291"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.05.018"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.01.1309"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2004.01.008"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093061"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2023.04.011"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-22-1387"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.01.031"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.11.036"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2022.12.038"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13480"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200808-094GO"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.32614\/RJ-2021-053"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(96)80418-0"},{"issue":"2","key":"e_1_2_10_21_1","first-page":"S113","article-title":"Surgery of the Airway: Historic Notes","volume":"8","author":"Cooper J. D.","year":"2016","journal-title":"Journal of Thoracic Disease"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0b013e32833e16fc"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38911-1"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)35626-0"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(97)00314-X"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200910-1573OC"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2003.07.016"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0b013e32833deca9"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-36352-z"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201508-1634OC"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200608-1079OC"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2023.06.016"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2022.08.047"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T15:04:57Z","timestamp":1732547097000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/ctr.70029"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70029","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-06-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70029"}}