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ISHLTv Recorded Webinars

ISHLTv_19 - Interactive Live Case Discussion: ECMO Bridge to Lung Transplant: A Bridge too Far?


Jul 28, 2021 4:30pm ‐ Jul 28, 2021 5:30pm


Members: Free

Description

Summary:
This interactive webinar will discuss some of the key issues associated with the “urgent referral for consideration of lung transplant in the patient with pulmonary hypertension who, not known to the transplant program, has crashed onto ECMO”. Following discussion of the index case, brief overviews will be provided by international experts on topics related to compromised assessment pathways, medical therapy of end-stage pulmonary hypertension, ECLS options and post-transplant care in the intensive care unit.

Moderators:
Glen Westall, FRACP, PhD, The Alfred Hospital, Melbourne, Australia
Erin Lowery, MD, MS, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

Welcome and Introductions
Glen Westall, FRACP, PhD, The Alfred Hospital, Melbourne, Australia

CASE PRESENTATION: Young Patient with Pulmonary Hypertension on ECMO
Thomas Crowhurst, MBBS BMedSci(Hons) BA FRACP, The Alfred Hospital, Melbourne, Australia
This case presentation will describe a young patient with pulmonary hypertension who crashes onto extracorporeal life support (ECLS) following insertion of a peripherally inserted central catheter (PICC line). Previously unknown to the referring lung transplant center, he is rapidly assessed, wait-listed and transplanted within 72 hours.

Topic #1: Transplanting Urgent Cases: Issues Related to Potentially Incomplete Psychosocial Assessment and Consent Processes
Brittany Koons, PhD, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
This talk will address issues related to the potential for incomplete psychosocial assessment and consent processes when critically sick patients are referred for consideration for urgent transplantation to a center have never previously met or assessed the patient’s suitability for transplantation.

Topic #2: ECMO Bridge to Recovery: Is there a role for pulmonary vasodilators?
Tanya McWilliams, MD, PhD, Auckland City Hospital, Auckland, New Zealand
This talk will address whether there is a role for “rescue” medical therapy in the patient with pulmonary hypertension who has rapidly deteriorated to the point they are requiring ECLS.

Topic #3: Bridge to Transplant: ECLS Options (VA ECMO vs Pumpless LAD)
Isabelle Opitz, MD, University Hospital Zurich, Zurich, Switzerland
This talk will address the ECLS-bridge-to-transplant options for patients with end-stage pulmonary hypertension including VA ECMO and pumpless LAD configurations

Topic #4: Post-transplant ECLS Support in the Intensive Care Unit
Juan Salgado, MD, Penn Medicine, Philadelphia, PA, USA
This talk will address the following post-transplant care including the extended use of ECLS to allow right ventricle re-modelling.

PANEL DISCUSSION
Led by Moderators

Panelists:

  • Glen Westall, Australia
  • Erin Lowery, USA
  • Thomas Crowhurst, Australia
  • Brittany Koons, USA
  • Tanya McWilliams, New Zealand
  • Isabelle Opitz, Switzerland
  • Juan Salgado, USA
  • Andrew Courtwright, USA

CLOSING REMARKS
Glen Westall, FRACP, PhD, The Alfred Hospital, Melbourne, Australia

ISHLT Announcements
Greg Schultz, ISHLT CEO

Speaker(s):

  • Glen Westall, FRACP, PhD, Consultant Chest and Lung Transplant Physician, Melbourne, Australia, The Alfred Hospital
  • Erin Lowery, MD, Medical Director, Lung Transplant Program, Madison, WI, USA, University of Wisconsin
  • Thomas Crowhurst, MBBS BMedSci(Hons) BA FRACP, Melbourne, Australia, The Alfred Hospital
  • Brittany Koons, PhD, Philadelphia, PA, USA, Hospital of the University of Pennsylvania
  • Tanya McWilliams, PhD, FRACP, Auckland, New Zealand, Auckland City Hospital
  • Isabelle Opitz, MD, Zurich, Switzerland, University Hospital Zurich
  • Juan Salgado, MD, Philadelphia, PA, USA, Penn Medicine
  • Andrew Courtwright, MD, PhD, Philadelphia, PA, USA, Penn Medicine

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