ISHLT Consensus Statement on the Perioperative Use of ECLS in Lung Transplantation: Part II - Intraoperative Considerations

Published 23 October 2024

Archer Kilbourne Martin, MD; Olaf Mercier, MD, PhD; Ashley Virginia Fritz, DO; Theresa A. Gelzinis, MD; Konrad Hoetzenecker, MD, PhD; Sandra Lindstedt, MD, PhDf; Nandor Marczin, MD, PhD; Barbara J. Wilkey, MD; Marc Schecter, MD; Haifa Lyster, PhD; Melissa Sanchez, DClinPsy; James Walsh, PhD; Orla Morrissey, MD, PhD; Bronwyn Levvey, PhD; Caroline Landry, CPC, MSc; Siavosh Saatee, MD; Sakhee Kotecha, MD; Juergen Behr, MD, PhD; Jasleen Kukreja, MD, PhD; Göran Dellgren, MD, PhD; Julien Fessler, MD; Brandi Bottiger, MD; Keith Wille, MD; Kavita Dave, MD; Basil S. Nasir, MD; David Gomez-De-Antonio, MD; Marcelo Cypel, MD, PhD; Anna K. Reed, MD, PhD

J Heart Lung Transplant. October 2024.

• Advanced Lung Failure & Transplantation
• Anesthesiology & Critical Care
• Consensus Document
• Nursing & Allied Health
• Pediatrics
• Pharmacy
• Publications & Journals
• Pulmonology
• Standards & Guidelines

The use of extracorporeal life support (ECLS) throughout the perioperative phase of lung transplantation requires nuanced planning and execution by an integrated team of multidisciplinary experts. To date, no multidisciplinary consensus document has examined the perioperative considerations of how to best manage these patients. To address this challenge, this perioperative utilization of ECLS in lung transplantation consensus statement was approved for development by the International Society for Heart and Lung Transplantation Standards and Guidelines Committee. International experts across multiple disciplines, including cardiothoracic surgery, anesthesiology, critical care, pediatric pulmonology, adult pulmonology, pharmacy, psychology, physical therapy, nursing, and perfusion, were selected based on expertise and divided into subgroups examining the preoperative, intraoperative, and postoperative periods. 

Following a comprehensive literature review, each subgroup developed recommendations to examine via a structured Delphi methodology. Following 2 rounds of Delphi consensus, a total of 39 recommendations regarding intraoperative considerations for ECLS in lung transplantation met consensus criteria. 

This intraoperative consensus focuses on presurgical planning for intraoperative implementation, intraoperative management, and considerations for future research and technological development for ECLS in lung transplantation.

Read at JHLT