Survival After Extracorporeal Membrane Oxygenation Bridge to Lung Retransplantation
Background: Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation. Despite success in select populations, candidates requiring ECMO bridge to retransplantation have historically had poor 1-year survival. This study aimed to examine the characteristics of...
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Elsevier
2025-03-01
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| Series: | Annals of Thoracic Surgery Short Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772993124003796 |
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| author | Jennifer L. Keen, MD Pranav Modi, MBBS Maria M. Crespo, MD Christian Bermudez, MD Andrew Courtwright, MD, PhD |
| author_facet | Jennifer L. Keen, MD Pranav Modi, MBBS Maria M. Crespo, MD Christian Bermudez, MD Andrew Courtwright, MD, PhD |
| author_sort | Jennifer L. Keen, MD |
| collection | DOAJ |
| description | Background: Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation. Despite success in select populations, candidates requiring ECMO bridge to retransplantation have historically had poor 1-year survival. This study aimed to examine the characteristics of the recipient, donor, and transplant procedure type to guide selection of candidates for ECMO bridge to retransplantation. Methods: This was a retrospective cohort study of all US adult lung retransplant recipients between May 5, 2005, and December 31, 2022. We evaluated 1-year survival of ECMO-bridged retransplant patients, stratified by time from initial transplant, procedure type (single or bilateral retransplant), and ECMO era (2005-2017 vs 2018-2022). Results: In this national cohort, 111 of 1296 (8.6%) retransplant recipients underwent ECMO bridge. One-year survival was worse for ECMO bridge retransplant recipients (52.2% vs 74.0%; P < .001) and has worsened in the contemporary era (2018-2022) of ECMO bridge to retransplantation compared with prior years (P = .03). Time from initial transplantation and use of bilateral retransplant after an initial bilateral transplant were most strongly associated with improved 1-year survival of ECMO-bridged retransplant recipients. Of bilateral recipients bridged to bilateral transplant more than 1 year after primary transplantation, survival was 65.9% in ECMO-bridged patients as opposed to 77.2% in nonbridged patients. Conclusions: Careful selection of candidates and surgical procedure type remains essential in determining candidacy for ECMO bridge to retransplantation. |
| format | Article |
| id | doaj-art-b8a03a7d4a8745eda0b9b45c77c8a795 |
| institution | OA Journals |
| issn | 2772-9931 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Thoracic Surgery Short Reports |
| spelling | doaj-art-b8a03a7d4a8745eda0b9b45c77c8a7952025-08-20T01:47:28ZengElsevierAnnals of Thoracic Surgery Short Reports2772-99312025-03-013115015510.1016/j.atssr.2024.09.018Survival After Extracorporeal Membrane Oxygenation Bridge to Lung RetransplantationJennifer L. Keen, MD0Pranav Modi, MBBS1Maria M. Crespo, MD2Christian Bermudez, MD3Andrew Courtwright, MD, PhD4Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Address correspondence to Dr Jennifer L. Keen, Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania, 800 Walnut St, 9th Flr, Philadelphia, PA 19107.Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MinnesotaPulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaCardiothoracic Surgery, University of Pennsylvania, Philadelphia, PennsylvaniaPulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, PennsylvaniaBackground: Extracorporeal membrane oxygenation (ECMO) is increasingly used as a bridge to lung transplantation. Despite success in select populations, candidates requiring ECMO bridge to retransplantation have historically had poor 1-year survival. This study aimed to examine the characteristics of the recipient, donor, and transplant procedure type to guide selection of candidates for ECMO bridge to retransplantation. Methods: This was a retrospective cohort study of all US adult lung retransplant recipients between May 5, 2005, and December 31, 2022. We evaluated 1-year survival of ECMO-bridged retransplant patients, stratified by time from initial transplant, procedure type (single or bilateral retransplant), and ECMO era (2005-2017 vs 2018-2022). Results: In this national cohort, 111 of 1296 (8.6%) retransplant recipients underwent ECMO bridge. One-year survival was worse for ECMO bridge retransplant recipients (52.2% vs 74.0%; P < .001) and has worsened in the contemporary era (2018-2022) of ECMO bridge to retransplantation compared with prior years (P = .03). Time from initial transplantation and use of bilateral retransplant after an initial bilateral transplant were most strongly associated with improved 1-year survival of ECMO-bridged retransplant recipients. Of bilateral recipients bridged to bilateral transplant more than 1 year after primary transplantation, survival was 65.9% in ECMO-bridged patients as opposed to 77.2% in nonbridged patients. Conclusions: Careful selection of candidates and surgical procedure type remains essential in determining candidacy for ECMO bridge to retransplantation.http://www.sciencedirect.com/science/article/pii/S2772993124003796 |
| spellingShingle | Jennifer L. Keen, MD Pranav Modi, MBBS Maria M. Crespo, MD Christian Bermudez, MD Andrew Courtwright, MD, PhD Survival After Extracorporeal Membrane Oxygenation Bridge to Lung Retransplantation Annals of Thoracic Surgery Short Reports |
| title | Survival After Extracorporeal Membrane Oxygenation Bridge to Lung Retransplantation |
| title_full | Survival After Extracorporeal Membrane Oxygenation Bridge to Lung Retransplantation |
| title_fullStr | Survival After Extracorporeal Membrane Oxygenation Bridge to Lung Retransplantation |
| title_full_unstemmed | Survival After Extracorporeal Membrane Oxygenation Bridge to Lung Retransplantation |
| title_short | Survival After Extracorporeal Membrane Oxygenation Bridge to Lung Retransplantation |
| title_sort | survival after extracorporeal membrane oxygenation bridge to lung retransplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2772993124003796 |
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