Six parameters were tested in the statistical analysis: the underlying lung disease, the listing status prior to the LTx, gender, preoperative MV and ECMO use (Table 6 and Fig. 1). The best results were obtained for cystic fibrosis patients, with two-thirds being survivors. Finally, the use of ECMO prior to LTx was the sole significant risk factor of death (HR = 2.77; 95% CI [1.26–6.11]) at multivariable analysis (Table 7).
Table 6:
Univariate analysis for the risk factor of death
| Factor | Death | Alive | P-value |
|---|---|---|---|
| Age (median and range) | 33 (17–66) | 29.5 (16–66) | 0.786 |
| Cystic fibrosis | 23 (34.8%) | 43 (65.2%) | 0.11 |
| Pulmonary fibrosis | 12 (48%) | 13 (52%) | 0.2 |
| Chronic obstructive pulmonary disease | 2 (40%) | 3 (60%) | 0.97 |
| Miscellaneous | 3 (60%) | 2 (40%) | 0.26 |
| Male | 18 (34.6%) | 34 (65.4%) | 0.37 |
| Female | 22 (44.9%) | 27 (55.1%) | 0.37 |
| Non-listed on RWL | 23 (46.9%) | 26 (53.1%) | 0.17 |
| Mechanical ventilation | 23 (46.9%) | 26 (53.1%) | 0.13 |
| Extracorporeal assistance in bridge to LTx | 19 (59.4%) | 13 (40.6%) | 0.002 |
| Factor | Death | Alive | P-value |
|---|---|---|---|
| Age (median and range) | 33 (17–66) | 29.5 (16–66) | 0.786 |
| Cystic fibrosis | 23 (34.8%) | 43 (65.2%) | 0.11 |
| Pulmonary fibrosis | 12 (48%) | 13 (52%) | 0.2 |
| Chronic obstructive pulmonary disease | 2 (40%) | 3 (60%) | 0.97 |
| Miscellaneous | 3 (60%) | 2 (40%) | 0.26 |
| Male | 18 (34.6%) | 34 (65.4%) | 0.37 |
| Female | 22 (44.9%) | 27 (55.1%) | 0.37 |
| Non-listed on RWL | 23 (46.9%) | 26 (53.1%) | 0.17 |
| Mechanical ventilation | 23 (46.9%) | 26 (53.1%) | 0.13 |
| Extracorporeal assistance in bridge to LTx | 19 (59.4%) | 13 (40.6%) | 0.002 |
LTx: lung transplantation; RWL: regular waiting list.
Table 6:
Univariate analysis for the risk factor of death
| Factor | Death | Alive | P-value |
|---|---|---|---|
| Age (median and range) | 33 (17–66) | 29.5 (16–66) | 0.786 |
| Cystic fibrosis | 23 (34.8%) | 43 (65.2%) | 0.11 |
| Pulmonary fibrosis | 12 (48%) | 13 (52%) | 0.2 |
| Chronic obstructive pulmonary disease | 2 (40%) | 3 (60%) | 0.97 |
| Miscellaneous | 3 (60%) | 2 (40%) | 0.26 |
| Male | 18 (34.6%) | 34 (65.4%) | 0.37 |
| Female | 22 (44.9%) | 27 (55.1%) | 0.37 |
| Non-listed on RWL | 23 (46.9%) | 26 (53.1%) | 0.17 |
| Mechanical ventilation | 23 (46.9%) | 26 (53.1%) | 0.13 |
| Extracorporeal assistance in bridge to LTx | 19 (59.4%) | 13 (40.6%) | 0.002 |
| Factor | Death | Alive | P-value |
|---|---|---|---|
| Age (median and range) | 33 (17–66) | 29.5 (16–66) | 0.786 |
| Cystic fibrosis | 23 (34.8%) | 43 (65.2%) | 0.11 |
| Pulmonary fibrosis | 12 (48%) | 13 (52%) | 0.2 |
| Chronic obstructive pulmonary disease | 2 (40%) | 3 (60%) | 0.97 |
| Miscellaneous | 3 (60%) | 2 (40%) | 0.26 |
| Male | 18 (34.6%) | 34 (65.4%) | 0.37 |
| Female | 22 (44.9%) | 27 (55.1%) | 0.37 |
| Non-listed on RWL | 23 (46.9%) | 26 (53.1%) | 0.17 |
| Mechanical ventilation | 23 (46.9%) | 26 (53.1%) | 0.13 |
| Extracorporeal assistance in bridge to LTx | 19 (59.4%) | 13 (40.6%) | 0.002 |
LTx: lung transplantation; RWL: regular waiting list.
Table 7:
Multivariate analysis
| Factor | Hazard ratio | 95% CI | P-value |
|---|---|---|---|
| Age | 0.99 | 0.952–1.031 | 0.659 |
| Cystic fibrosis | 0.25 | 0.06–1.05 | 0.06 |
| Pulmonary fibrosis | 0.68 | 0.18–2.59 | 0.57 |
| Chronic obstructive pulmonary disease | 0.53 | 0.09–3.33 | 0.50 |
| Miscellaneous | 1 | ||
| Male | 1 | 0.329 | |
| Female | 1.39 | 0.72–2.70 | |
| Non-listed on the RWL | 1.14 | 0.59–2.23 | 0.696 |
| Mechanical ventilation | 0.99 | 0.47–2.09 | 0.983 |
| Extracorporeal assistance in bridge to LTx | 2.77 | 1.26–6.11 | 0.01 |
| Factor | Hazard ratio | 95% CI | P-value |
|---|---|---|---|
| Age | 0.99 | 0.952–1.031 | 0.659 |
| Cystic fibrosis | 0.25 | 0.06–1.05 | 0.06 |
| Pulmonary fibrosis | 0.68 | 0.18–2.59 | 0.57 |
| Chronic obstructive pulmonary disease | 0.53 | 0.09–3.33 | 0.50 |
| Miscellaneous | 1 | ||
| Male | 1 | 0.329 | |
| Female | 1.39 | 0.72–2.70 | |
| Non-listed on the RWL | 1.14 | 0.59–2.23 | 0.696 |
| Mechanical ventilation | 0.99 | 0.47–2.09 | 0.983 |
| Extracorporeal assistance in bridge to LTx | 2.77 | 1.26–6.11 | 0.01 |
LTx: lung transplantation; RWL: regular waiting list.
Table 7:
Multivariate analysis
| Factor | Hazard ratio | 95% CI | P-value |
|---|---|---|---|
| Age | 0.99 | 0.952–1.031 | 0.659 |
| Cystic fibrosis | 0.25 | 0.06–1.05 | 0.06 |
| Pulmonary fibrosis | 0.68 | 0.18–2.59 | 0.57 |
| Chronic obstructive pulmonary disease | 0.53 | 0.09–3.33 | 0.50 |
| Miscellaneous | 1 | ||
| Male | 1 | 0.329 | |
| Female | 1.39 | 0.72–2.70 | |
| Non-listed on the RWL | 1.14 | 0.59–2.23 | 0.696 |
| Mechanical ventilation | 0.99 | 0.47–2.09 | 0.983 |
| Extracorporeal assistance in bridge to LTx | 2.77 | 1.26–6.11 | 0.01 |
| Factor | Hazard ratio | 95% CI | P-value |
|---|---|---|---|
| Age | 0.99 | 0.952–1.031 | 0.659 |
| Cystic fibrosis | 0.25 | 0.06–1.05 | 0.06 |
| Pulmonary fibrosis | 0.68 | 0.18–2.59 | 0.57 |
| Chronic obstructive pulmonary disease | 0.53 | 0.09–3.33 | 0.50 |
| Miscellaneous | 1 | ||
| Male | 1 | 0.329 | |
| Female | 1.39 | 0.72–2.70 | |
| Non-listed on the RWL | 1.14 | 0.59–2.23 | 0.696 |
| Mechanical ventilation | 0.99 | 0.47–2.09 | 0.983 |
| Extracorporeal assistance in bridge to LTx | 2.77 | 1.26–6.11 | 0.01 |
LTx: lung transplantation; RWL: regular waiting list.
Figure 1:
Survival curves comparing ECMO use before LTx. ECMO: extracorporeal membrane oxygenation; LTx: lung transplantation.
