AUTHOR=Kim Gyungah , Ahn Jee Hwan , Shim Tae Sun , Kang Pil-Je , Lee Geun Dong , Choi Sehoon , Kim Won , Jung Sung-Ho , Kim Dong Kwan , Park Seung-Il , Hong Sang-Bum 

TITLE=Improved Results Over Time With Bridge-to-Lung Transplantation: A 10-Year Experience of a Single High-Volume Center

JOURNAL=Transplant International

VOLUME=Volume 38 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.13944

DOI=10.3389/ti.2025.13944

ISSN=1432-2277

ABSTRACT=When donor scarcity limits timely lung transplantation (LTx), extracorporeal membrane oxygenation (ECMO) as a bridge to transplantation (BTT) can prolong survival and delay deconditioning until the donor lungs become available. We reviewed 10-year BTT experiences from 2008 to 2021 of a single high-volume center, where 99 (59%) patients were on ECMO BTT among 169 adult LTx cases. Both 28-day and 2-year survivals did not differ between BTT and non-BTT. Next, the BTT data was divided into two periods using the most recent 3 years as a cutoff. The clinical outcomes of the earlier period ("Period 1") and the later period ("Period 2") were compared, and mortality within 28 days of LTx was significantly lower in Period 2 (14.6% vs. 1.7%, p<0.01). Improved survival was observed mostly in subgroups with BTT duration for longer than or equal to 14 days. Taken together, accumulation of experiences in BTT over time and development of competence may promote patient survival in LTx as shown in improved 28-day survival in the recent period ("Period 2"), especially in patients with longrun (more than 14 days) ECMO care.