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Extracorporeal membrane oxygenation as a bridge to lung transplantation: analysis of Korean organ transplantation registry (KOTRY) data

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Authors
Ko, Ryoung-Eun; Lee, Jin Gu; Kim, Song Yee; Kim, Young Tae; Choi, Sun Mi; Kim, Do Hyung; Cho, Woo Hyun; Park, Seung-Il; Jo, Kyung-Wook; Kim, Hong Kwan; Paik, Hyo Chae; Jeon, Kyeongman
Issue Date
2020-01-13
Publisher
BMC
Citation
Respiratory Research, 21(1):20
Keywords
Lung transplantationExtracorporeal membrane oxygenationsBridge to transplantTreatment outcome
Abstract
Background
The use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation has greatly increased. However, data regarding the clinical outcomes of this approach are lacking. The objective of this multicenter prospective observational cohort study was to evaluate lung transplantation outcomes in Korean Organ Transplantation Registry (KOTRY) patients for whom ECMO was used as a bridge to transplantation.

Methods
Between March 2015 and December 2017, a total of 112 patients received lung transplantation and were registered in the KOTRY, which is a prospective, multicenter cohort registry. The entire cohort was divided into two groups: the control group (n = 85, 75.9%) and bridge-ECMO group (n = 27, 24.1%).

Results
There were no significant differences in pre-transplant and intraoperative characteristics except for poorer oxygenation, more ventilator use, and longer operation time in the bridge-ECMO group. The prevalence of primary graft dysfunction at 0, 24, 48, and 72 h after transplantation did not differ between the two groups. Although postoperative hospital stays were longer in the bridge-ECMO group than in the control group, hospital mortality did not differ between the two groups (25.9% vs. 13.3%, P = 0.212). The majority of patients (70.4% of the bridge-ECMO group and 77.6% of the control group) were discharged directly to their homes. Finally, the use of ECMO as a bridge to lung transplantation did not significantly affect overall survival and graft function.

Conclusions
Short- and long-term post-transplant outcomes of bridge-ECMO patients were comparable to recipients who did not receive ECMO.
ISSN
1465-993X
Language
English
URI
https://doi.org/10.1186/s12931-020-1289-2

http://hdl.handle.net/10371/164920
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College of Medicine/School of Medicine (의과대학/대학원)Thoracic Surgery (흉부외과학전공)Journal Papers (저널논문_흉부외과학전공)
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