Complications associated with bridging to lung transplantation - systematic review and meta-analysis

Introduction: Lung transplantation (LuTx) is a treatment method of end-stage pulmonary diseases when conventional therapy does not provide further improvement. Preoperative use of extracorporeal life support is known as bridging to LuTx and is associated with several complications. Aim of the research: To investigate the frequencies of complications that may develop during bridging to lung transplantation with extracorporeal life support. Material and methods: A thorough, systematic review in the Medline and Google Scholar databases was performed. Inclusion criteria consisted of studies with or without a control group reporting experience with bridging to lung transplantation. Preferred reporting items for systematic reviews and meta-analysis protocols were used. Forest plots were generated with Open Meta Analyst software. Heterogeneity was assessed using I2 statistics. Results: Thirteen studies met the inclusion criteria. The articles were published between 2011 and 2020. A total of 461 patients bridged to transplantation were included. Bleeding and thrombotic complications occurred in 24.6% of patients; cerebrovascular events were observed in 4.5%; while renal replacement therapy was implemented in 13.2% of the included patients. Conclusions: Frequencies of possible complications occurring during a bridging procedure cannot be overlooked and may lead to death instead of lifesaving surgery.