Extracorporeal membrane oxygenation and retransplantation in lung transplantation: An analysis of the UNOS registry

Don Hayes, Robert Higgins, Ahmet Kilic, Stephen Kirkby, Amy L. Pope-Harman, Thomas J. Preston, Bryan A. Whitson

Research output: Contribution to journalArticle

Abstract

Background: Despite limited organ availability, extracorporeal membrane oxygenation (ECMO) and retransplantation are becoming more commonplace. Methods: Using the United Network for Organ Sharing (UNOS) database, we evaluated survival of patients treated with ECMO before lung transplantation and undergoing retransplantation. A query identified cadaveric recipients from 2001 to 2012 over the age of 6 years. Results: Of 15,772 lung recipients, 15 583 never received ECMO, whereas 189 did. Mean age was 52.1 ± 14.4 versus 46.8 ± 16.5 years for non-ECMO and ECMO groups, respectively (p <0.0001). Using Kaplan-Meier method, there were survival differences between ECMO and non-ECMO groups (p <0.0001) and first-time transplants with and without ECMO to retransplants with and without ECMO (p <0.0001). The proportional hazards model identified higher risk with ECMO use in idiopathic pulmonary fibrosis (hazard ratio [HR] 1.09; 95 % confidence interval (CI), 1.02-1.17; p = 0.014) and retransplants (HR 1.77; 95 % CI, 1.55-2.03; p <0.0001). Conclusions: Survival for retransplantation was similar to ECMO as a primary option with significant mortality associated with ECMO use in patients with idiopathic pulmonary fibrosis and retransplants.

Original languageEnglish (US)
Pages (from-to)571-576
Number of pages6
JournalLung
Volume192
Issue number4
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Keywords

  • Extracorporeal life support
  • Extracorporeal membrane oxygenation
  • Lung transplantion
  • Pretransplant
  • Retransplantion
  • Survival

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)

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