• Don Hayes, Robert S Higgins, Ahmet Kilic, Stephen Kirkby, Amy L Pope-Harman, Thomas J Preston, and Bryan A Whitson.
• Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA, hayes.705@osu.edu.
• Lung. 2014 Aug 1;192(4):571-6.

BackgroundDespite limited organ availability, extracorporeal membrane oxygenation (ECMO) and retransplantation are becoming more commonplace.MethodsUsing 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.ResultsOf 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).ConclusionsSurvival 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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