Outcomes of transplant recipients on ECMO for COVID-19 respiratory failure: an ELSO registry study
Authors' conclusion
Mortality was high in COVID-19 transplant ECMO patients
Study context
- Population
- ECMO runs in the Extracorporeal Life Support Organization Registry, 1/1/2017 to 31/07/2023ECMO runs in registry
- Participants
- 38,270 runs
- Exposure
- Transplant COVID-19 vs Non-IC COVID-19 vs Transplant non-COVID-19
- Transplant COVID-19n = 146
- Non-IC COVID-19n = 12,552reference
- Transplant non-COVID-19n = 886reference
- Outcome
- In-hospital mortality
Methodological detailsregistry, propensity score-adjusted, multivariable and propensity score (PS)-matched analyses
- Registry
- Propensity score-adjusted, multivariable and PS-matched analyses
Main finding
As reported in the abstract
Transplant COVID-19
75.3%
Odds ratio (95% CI)P value
Transplant COVID-19 vs Non-IC-COVID-19PS-adjusted
2.36(1.61–3.46)
P < 0.001Transplant COVID-19 vs Non-IC-COVID-19multivariable
2.35(1.59–3.49)
P < 0.001Transplant COVID-19 vs Non-IC-COVID-19PS-matched
1.89(1.21–2.95)
P < 0.005Transplant COVID-19 vs Transplant non-COVID-19PS-adjusted
4.20(2.74–6.44)
P < 0.001Transplant COVID-19 vs Transplant non-COVID-19multivariable
3.79(2.51–5.74)
P < 0.001Transplant COVID-19 vs Transplant non-COVID-19PS-matched
3.17(1.90–5.28)
P < 0.001Observational data: associations, not effects.
Further findings
Mortality difference over time
- Mortality difference remained stable over time
Factors associated with mortality among transplant COVID-19
- Older age independently associated with higher mortality
Need for RRT
- Higher need for RRT in transplant COVID-19 vs non-IC-COVID-19
ECMO run duration and time-to-live discharge
- Prolonged in transplant COVID-19 vs transplant non-COVID-19
Original publication
Outcomes of transplant recipients on ECMO for COVID-19 respiratory failure: an ELSO registry study. Crit Care. Published 25 September 2025. doi:10.
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