title: Survival in children on extracorporeal membrane oxygenation at the time of lung transplantation.
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 (<18 yr) 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.
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University, Columbus, OH, USA; Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
authors.forename: Patrick I
authors.initials: PI
authors.lastname: McConnell
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Whitson
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Preston
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Yates
authors.forename: Mark
authors.initials: M
authors.lastname: Galantowicz
mesh_terms: D000293:Adolescent; D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000401:mortality*; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: children; extracorporeal membrane oxygenation; lung transplantation; survival