Suboptimal Six Minute Walk Distance Does Not Impact Survival in Lung Transplant Recipients Bridged with Extracorporeal Support

Purpose Preoperative six-minute walk distance (6MWD) is associated with survival following lung transplantation; however, its predictive value remains unclear for patients on extracorporeal support (ECMO). Our study aimed to assess the impact of ECMO utilization on posttransplant survival among patients with suboptimal 6MWD. Methods Using data from the United Network for Organ Sharing, we included adult, first-time lung transplant recipients between May 3, 2005 and March 20, 2020 with suboptimal 6MWD ( Results Our overall study population included 21,266 patients: 60 in the ECMO cohort and 21,206 in the non-ECMO cohort. Both cohorts were predominantly male (57% in ECMO cohort vs. 58%, p = 0.972). In the ECMO cohort, the median age was lower (49 years, IQR 34-56 vs. 60 years, IQR 53-65; p 0) and non-ambulatory (6MWD = 0) patients (log rank, p = 0.536). Overall, no survival difference by ECMO status at 3 years was observed (log rank, p=0.718; Figure 1). Conclusion Our results suggest that ECMO, in appropriately selected patients, does not significantly impact postoperative survival compared to a population with similar suboptimal pretransplant functional status. Furthermore, no minimum distance was observed that conferred better or worse outcomes.