Out-of-bed mobility during venovenous ECMO among patients listed for lung transplantation: A descriptive...

Out-of-bed (OOB) mobility is often expected of patients bridged to lung transplantation (LTx) on venovenous (VV) extracorporeal membrane oxygenation (ECMO), but the course of listed patients who never achieve it is poorly described. We describe mobility and outcomes in these patients at one center.

We retrospectively reviewed patients bridged to LTx with VV ECMO between January 2019 and June 2025 at one center; the analytic cohort was restricted to listed patients. OOB mobility was a maximum nurse-rated score ≥5 on a 7-point institutional scale. Outcomes included 1-year post-transplant survival, survival to LTx, hospital survival, discharge disposition, length of stay, ventilation duration, and tracheostomy, reported descriptively with exact 95% confidence intervals (CIs).

Of 23 listed patients, 20 (87.0%) achieved OOB mobility and 3 (13.0%) did not. All 3 who never mobilized underwent transplantation and survived to discharge and to 1 year (3/3; 95% CI, 29.2-100). Among the 20 who mobilized, 19 survived to LTx (95.0%; 95% CI, 75.1-99.9), 18 to discharge (90.0%; 95% CI, 68.3-98.8), and 17 of the 19 transplanted to 1 year (89.5%; 95% CI, 66.9-98.7). Intervals were wide and overlapping. Four further patients were assessed but not listed; none achieved OOB mobility, and all died without transplantation.

Three listed patients who never achieved OOB mobility were transplanted and survived to 1 year. Because the cohort is conditioned on prior acceptance for listing and the comparison group contains three patients, these observations are descriptive and cannot determine how OOB mobility should weigh in candidacy decisions.