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

 Ryoung-Eun Ko  ;  Jin Gu Lee  ;  Song Yee Kim  ;  Young Tae Kim  ;  Sun Mi Choi  ;  Do Hyung Kim  ;  Woo Hyun Cho  ;  Seung-Il Park  ;  Kyung-Wook Jo  ;  Hong Kwan Kim  ;  Hyo Chae Paik  ;  Kyeongman Jeon  ;  Korean Organ Transplantation Registry Study Group 
 RESPIRATORY RESEARCH, Vol.21(1) : 20, 2020-01 
Journal Title
Issue Date
Cohort Studies ; Data Analysis* ; Extracorporeal Membrane Oxygenation / methods* ; Extracorporeal Membrane Oxygenation / trends ; Female ; Follow-Up Studies ; Humans ; Lung Transplantation / methods* ; Lung Transplantation / trends ; Male ; Middle Aged ; Prospective Studies ; Registries* ; Republic of Korea / epidemiology ; Treatment Outcome
Bridge to transplant ; Extracorporeal membrane oxygenations ; Lung transplantation ; Treatment outcome
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Lee, Jin Gu(이진구)
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