PURPOSE: Extracorporeal Membrane Oxygenation (ECMO) is a lifesaving procedure in lung transplant recipients with severe primary graft dysfunction (PGD). There is limited information regarding the impact of post-op ECMO on lung allograft function. Circulating donor-derived cell-free DNA (dd-cf-DNA) has emerged as a potential biomarker of lung allograft injury. The goal of our study is to compare the dynamic dd-cf-DNA changes in patients that required ECMO support with changes in lung transplant patients that did not require ECMO. METHODS: Peri-transplant (pre-transplant and days 1, 3, 7 and 10, 14, 30, 60, 90 post-transplantation) plasma samples from lung transplant recipients (LTRs)of the Genomic Research Alliance for Transplantation (GRAfT) were analyzed for dd-cf-dDNA by next generation sequencing. After matching for gender, type of transplant (single versus double), and underlying diagnosis, the dd-cf-DNA levels and 3 month post-transplant lung function was compared among patients who required (n=9) and did not require (n=45) ECMO post-operatively. RESULTS: The dd-cf-DNA levels were similar between patients with PGD that required ECMO compared to non ECMO patients. The dd-cf-DNA levels for both ECMO patients and their matched controls were decreased by day 10 (Figure 1). The figure illustrates dd-cf-DNA trends for 2 matched cases (ECMO) and 10 controls (not ECMO), showing high initial post-transplant dd-cf-DNA levels followed by an exponential decay. There was no difference between lung function (FEV1) at 3 months between the ECMO patients and their matched controls (p=0.27)-Figure 2. CONCLUSION: This report suggests that despite a higher risk for postoperative mortality, patients with severe primary graft failure requiring ECMO had similar cfDNA dynamics and lung function at 3-months post-transplant.
|Original language||English (US)|
|Journal||The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation|
|State||Published - Apr 1 2020|
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Cardiology and Cardiovascular Medicine