Extracorporeal Life Support as a Bridge to Lung Transplantation: A Single-Center Experience With an Emphasis on Health-Related Quality of Life.
BACKGROUND
Extracorporeal life support (ECLS) as a bridge to lung transplantation is increasingly used, but information on long-term outcome is scarce. We aim to summarize our experience with an emphasis on health-related quality of life. Secondary outcomes include ICU and hospital stay and pre- and post-transplant mortality.


METHODS
A retrospective cohort study of all adult subjects receiving ECLS as a bridge to lung transplantation from 2010 to 2014 was reviewed and compared with all adult subjects who underwent bilateral lung transplantation in the same period. For the ECLS group, the general health status was assessed with the use of the EuroQol Group 5-Dimension Self-Report Questionnaire.


RESULTS
A total of 130 bilateral transplants were performed, 9 transplants were performed after ECLS therapy. Another 11 subjects died on the waiting list while receiving ECLS. Quality of life, at 12 months after surgery, from a subject's perspective was comparable in both groups with a median score of 80 on the visual analog scale. The median (interquartile range [IQR]) EuroQol Group 5-Dimension Self-Report Questionnaire 3L score from the societal perspective in the ECLS group was 0.73 (0.5-0.9). Median (IQR) ICU stay was 25 d (9-68 d) for the ECLS group versus 7 d (4-18 d) for the control group (P= .001), and in-hospital stay was 66 d (40-114 d) versus 42 d (29-62 d) (P= .004).


CONCLUSIONS
ECLS can be used as a bridge to lung transplantation. A significant number of subjects were not bridged successfully due to different reasons. Outcomes after successful transplantation after ECLS might be comparable with the general population undergoing lung transplantation in terms of quality of life, lung function, performance tests, and mortality, although ICU and hospital stay are longer.
Department of Critical Care a.oudelansink@umcg.nl.
Annemieke Oude
AO
Lansink-Hartgring
Department of Pulmonary Diseases and Lung Transplantation.
Wim
W
van der Bij
Department of Pulmonary Diseases and Lung Transplantation.
Erik A
EA
Verschuuren
Department of Cardiothoracic Surgery.
Michiel E
ME
Erasmus
Department of Anesthesiology.
Adrianus J
AJ
de Vries
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Karin M
KM
Vermeulen
Department of Critical Care.
Walter M
WM
van den Bergh
D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods / Q000401:mortality*; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods / Q000401:mortality*; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists / Q000401:mortality
extracorporeal life support; health-related quality of life; lung transplantation; quality of life