Abstract
Limited data exist on ECMO at the time of LTx in children. The UNOS database was queried from 2000 to 2013 for pediatric lung transplant recipients (<18yr) to assess post-transplant survival of patients on ECMO at the time of LTx. Of 587 pediatric recipients with 17 on ECMO, 585 were used for univariate and Kaplan-Meier function analysis, 535 for multivariate Cox models, and 24 for propensity score matching. Univariate Cox (HR=1.777; 95% CI: 0.658, 4.803; p=0.257) and Kaplan-Meier function (log-rank test: chi-square (df=1): 1.32, p=0.250) analyses did not identify a survival difference between ECMO and non-ECMO, while multivariate Cox models (HR=1.821; 95% CI: 0.654, 5.065; p=0.251) did not demonstrate an increased risk for death. Propensity score matching analysis (HR=1.500; 95% CI: 0.251, 8.977; p=0.657) also failed to demonstrate a significantly increased hazard ratio. Using a contemporary cohort of pediatric lung transplant recipients, the use of ECMO at the time of lung transplantation did not negatively impact survival.
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