Key result
Selective VA-ECMO serves as the preferred intraoperative support strategy across ~78% of Italian lung transplant centres.
Why the study?
Significant variability persists in the use of extracorporeal life support during adult lung transplantation despite recent international consensus recommendations, motivating a national characterization of contemporary practice patterns among Italian lung transplant centres.
Cross-Sectional (n=9)
Yes
Substantial variability remains in intraoperative and postoperative ECLS management across Italian lung transplant centres despite recent international consensus recommendations, though VA-ECMO and selective ECLS use are preferred by the majority (77.8%).
Answers are grounded in this paper and cite their sources.
Highlights institutional variability in ECLS use; leaves open evidence-based standardization for bilateral lung transplantation.
The use of extracorporeal life support (ECLS) during lung transplantation has evolved substantially. Despite recent international consensus recommendations, significant variability persists. We conducted a national survey to describe contemporary practice patterns among Italian lung transplant centres. A 39-item, web-based survey was developed and distributed to all nine Italian lung transplant centres. The survey addressed indications for ECLS, technical aspects of extracorporeal support, anticoagulation and postoperative management. The response rate was 100%. Seven centres (77.8%) reported selective use of ECLS, whereas two (22.2%) routinely used ECLS during bilateral lung transplantations. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was the preferred intraoperative support modality in seven centres (77.8%), while two centres (22.2%) preferred cardiopulmonary bypass. Considerable variability was observed in patient selection, anticoagulation, cannulation strategies, postoperative ECLS continuation and weaning practices. Substantial variability remains in ECLS management among Italian lung transplant centres, despite recent international consensus recommendations. These findings provide a contemporary national overview of ECLS practice and highlight the need for further patient-level and outcome-based evaluation of intraoperative ECLS strategies.
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Costamagna et al. (2026) conducted a cross-sectional in Adult lung transplantation (n=9). Extracorporeal life support (ECLS) practices was evaluated on Selective planned ECLS use and preferred intraoperative support modality (VA-ECMO) during bilateral lung transplantation. Selective extracorporeal life support using veno-arterial ECMO was the preferred intraoperative strategy in 77.8% of Italian lung transplant centres during bilateral lung transplantation.
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