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Effects of the duration of bridge to lung transplantation with extracorporeal membrane oxygenation

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Abstract
Background Although bridge to lung transplantation (BTT) with extracorporeal membrane oxygenation (ECMO) is increasingly performed, the impact of BTT and its duration on post-transplant outcomes are unclear. Methods We retrospectively reviewed medical records of adult patients who underwent lung or heart-lung transplantation in our institution between January 2008 and December 2018. Data were compared in patients who did (n = 41; BTT) and did not (n = 36; non-BTT) require pre-transplant ECMO support. Data were also compared in patients who underwent short-term (<14 days; n = 21; ST-BTT) and long-term (>= 14 days; n = 20; LT-BTT) BTTs. Results Among 77 patients included, 51 (66.2%) were male and median age was 53 years. The median bridging time in the BTT group was 13 days (interquartile range [IQR], 7-19 days). Although simplified acute physiologic score II was significantly higher in the BTT group (median, 35; IQR, 31-49 in BTT group vs. median, 12; IQR, 7-19 in non-BTT group; p<0.001), 1-year (73.2% vs. 80.6%; p = 0.361) and 5-year (61.5% vs. 61.5%; p = 0.765) post-transplant survival rates were comparable in both groups. Comparison of ST- and LT-BTT subgroups showed that 1-year (90.5% vs. 55.0%; p = 0.009) and 5-year (73.0% vs. 48.1%; p = 0.030) post-transplant survival rates were significantly higher in ST-BTT group. In age and sex adjusted model, the LT-BTT was an independent risk factor for 1-year post-transplant mortality (hazard ratio, 3.019; 95% confidence interval, 1.119-8.146; p = 0.029), whereas the ST-BTT was not. Conclusions Despite the severe illness, the BTT group showed favorable post-transplantation outcomes, particularly those bridged for less than 14 days.
Author(s)
김동관김원박승일심태선이근동최세훈홍상범Dong Kyu Oh
Issued Date
2021
Type
Article
Keyword
AdultExtracorporeal Membrane Oxygenation / methods*FemaleHeart-LungTransplantation / methods*Heart-Lung Transplantation / mortality*HumansLungransplantation / methodsLung Transplantation / mortalityMaleMiddle AgedRetrospective StudiesSurvival RateTissue Donors / statistics &amp; numerical data*Treatment OutcomeWaiting Lists / mortality*
DOI
10.1371/journal.pone.0253520
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7122
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_plos_journals_2547541313&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Effects%20of%20the%20duration%20of%20bridge%20to%20lung%20transplantation%20with%20extracorporeal%20membrane%20oxygenation&amp;offset=0&amp;pcAvailability=true
Publisher
PLOS ONE
Location
미국
Language
영어
ISSN
1932-6203
Citation Volume
16
Citation Number
7
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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