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Extracorporeal Membrane Oxygenation and Retransplantation in Lung Transplantation: An Analysis of the UNOS Registry

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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.

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Conflict of interest

The authors report no conflicts of interest and have no relevant disclosures.

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Authors and Affiliations

  1. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    Don Hayes Jr. & Stephen Kirkby

  2. Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA

    Don Hayes Jr., Stephen Kirkby & Amy L. Pope-Harman

  3. Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA

    Robert S. Higgins, Ahmet Kilic & Bryan A. Whitson

  4. The Ohio State University, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Don Hayes Jr., Stephen Kirkby & Thomas J. Preston

  5. The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Don Hayes Jr., Robert S. Higgins, Ahmet Kilic, Stephen Kirkby, Amy L. Pope-Harman & Bryan A. Whitson

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  1. Don Hayes Jr.
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  2. Robert S. Higgins
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Correspondence to Don Hayes Jr..

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Hayes, D., Higgins, R.S., Kilic, A. et al. Extracorporeal Membrane Oxygenation and Retransplantation in Lung Transplantation: An Analysis of the UNOS Registry. Lung 192, 571–576 (2014). https://doi.org/10.1007/s00408-014-9593-6

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  • DOI: https://doi.org/10.1007/s00408-014-9593-6

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