Stratification Risk Analysis in Bridging Patients to Lung Transplant on ECMO: The STABLE Recipient Risk Score

Abstract

Purpose No recipient risk index for in-hospital mortality of patients bridged to lung transplantation (LTP) using ECMOhas been clinically validated. We queried the UNOS database to generate a novel quantitative recipient risk score. Methods Since 2004 a total of 783 patients in the US were bridged to LTP using ECMO. Patients Results 6 pretransplant recipient specific variables were translated into a 26 point scoring system (Table 1). Derivation and validation cohort scores ranged between 0-22 and 0-24, with ROC areas under the curve of 71% and 75%, respectively (Figure 1A, 1B). In both derivation (Figure 1C) and validation (Figure 1D) cohort, each STABLE point increased the odds of in-hospital mortality by 22% (OR 1.22 [1.14-1.31, p Conclusion The STABLE score is a novel and validated tool for recipient risk stratification of patients on ECMO bridge to LTP. High predictive power of in-hospital mortality may aid clinical decision making and organ allocation.