Long-term outcome and bridging success of patients evaluated and bridged to lung transplantation on the ICU

C. Tji Gan*, Rogier A.S. Hoek, Wim van der Bij, Caroline Van De Wauwer, Michiel E. Erasmus, Annemiek Oude Lansink-Hartgring, Joep M. Droogh, Leonard Seghers, Bas J. Mathot, Edris A.F. Mahtab, Jos A. Bekkers, Dinis Dos Reis Miranda, Erik A.M. Verschuuren, Merel E. Hellemons

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)

Abstract

Background: 

Evaluating and bridging patients to lung transplantation (LTx) on the intensive care unit (ICU) remains controversial, especially without a previous waitlist status. Long term outcome data after LTx from ICU remains scarce. We compared long-term survival and development of chronic lung allograft dysfunction (CLAD) in elective and LTx from ICU, with or without previous waitlist status. 

Methods: 

Patients transplanted between 2004 and 2018 in 2 large academic Dutch institutes were included. Long-term survival and development of CLAD was compared in patients who received an elective LTx (ELTx), those bridged and transplanted from the ICU with a previous listing status (BTT), and in patients urgently evaluated and bridged on ICU (EBTT). 

Results: 

A total of 582 patients underwent a LTx, 70 (12%) from ICU, 39 BTT and 31 EBTT. Patients transplanted from ICU were younger than ELTx (46 vs 51 years) and were bridged with mechanical ventilation (n = 42 (60%)), extra corporeal membrane oxygenation (n = 28 (40%)), or both (n = 21/28). Bridging success was 48% in the BTT group and 72% in the EBTT group. Patients bridged to LTx on ICU had similar 1 and 5 year survival (86.8% and 78.4%) compared to elective LTx (86.8% and 71.9%). This was not different between the BTT and EBTT group. 5 year CLAD free survival was not different in patients transplanted from ICU vs ELTx. 

Conclusion: 

Patients bridged to LTx on the ICU with and without prior listing status had excellent short and long-term patient and graft outcomes, and was similar to patients electively transplanted.

Original languageEnglish
Pages (from-to)589-598
Number of pages10
JournalJournal of Heart and Lung Transplantation
Volume41
Issue number5
DOIs
Publication statusPublished - May 2022

Bibliographical note

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