Is MFI Value a Solid Ground to Listing Unacceptable HLA Antigens

s S125 in the increased use of ECMO as a bridge to transplant to minimise waitlist mortality. There is limited data on the use of ECMO prior to LTx in paediatrics and physical outcomes are not well documented. This study aims to evaluate the short-term physical outcomes of pts bridged to LTx via ECMO. Methods: A retrospective analysis was performed of all paediatric pts at a tertiary hospital (n= 4, median age= 13) who underwent bilateral sequential lung transplant (BSLTx) following ECMO support. Indications for transplant included cystic fibrosis (n= 1), acute lung injury (1) and pulmonary vascular disease (2). All pts participated in a supervised, intensive outpatient (OP) exercise rehabilitation program for 1 hour, 3 times a week for 1-3 months. 6 minute walk test (6MWT) results were compared post rehabilitation to a paired cohort of 6 paediatric pts who underwent BSLTx without the need for ECMO pre LTx. Results: Survival at 3 months was 100% for both groups. All pts were female. ECMO support (VA n= 2, VV n= 2) was for a median of 18 days (range 2-35). Median time spent in OP rehabilitation for both groups was 72.5 days (ECMO range 37-80, control 42-77), p= 0.67. 6MWT results on discharge from OP rehabilitation tended to be higher in the ECMO group: median 520m (range 351-557) vs non-ECMO: median 476m (339-503), p= 0.13. All pts progressed to high level physical ability, denoted by jogging or running independently post rehabilitation. Conclusion: The use of ECMO as a bridge to LTx was not shown to be detrimental to short-term physical outcomes based on 6MWT distance. According to available literature, 5/10 pts (3 ECMO, 2 control) achieved a 6MWT distance within the range for healthy paediatrics. Future challenges will include the increasing use of ECMO, in particular, ambulatory circuitry, and the effect of this on short and long-term physical outcomes post paediatric LTx.