Age and Era-Based Survival Differences in Thoracic Transplantation Patients Who Require ECMO

Abstract

Purpose Extracorporeal membrane oxygenation (ECMO) may be used to support heart and heart-lung transplant recipients with early graft dysfunction or postoperative cardiopulmonary failure. The incidence, survival rate and risk factors for death have not been established. Methods and Materials Data from patients who received ECMO following heart or heart-lung transplantation between 1989-2012 were obtained from the Extracorporeal Life Support Organization Registry and analyzed for trends in ECMO usage, survival, complications and risk factors for death. Results ECMO was used to support 892 heart (93%) and heart-lung (7%) transplant recipients, representing 1.8% of all patients in the registry. Survival to hospital discharge significantly improved over time from 38% (prior to 2000) to 51% (2000-2005) to 58% (2006-2012) (P Conclusions Hospital survival for heart and heart-lung transplant recipients who require ECMO has improved over time while overall ECMO and overall early transplant survival rates have remained stable. This finding suggests that patient selection criteria for ECMO in the early post-transplant period may have shifted over time and when appropriately utilized, ECMO is an effective support therapy for transplant patients with life-threatening cardiopulmonary failure.