Dr Venado and colleagues, underlining that patients undergoing transplant after ECMO bridging have a good outcome,1-3 express some skepticism about the relationship between ECMO duration and unfavorable results. When considering all patients admitted to an ECMO bridge program and pooling together bridges of different duration, a good 1-year survival rate1-3 does not imply that ECMO duration is irrelevant. Indeed, the effects of bridge duration cannot be inferred from the data reported in the Toyoda et al2 case series. In the report of Hoopes et al,3 we observe a trend toward lower 1-year survival in long-term ECMO, with eight of 10 survivors in the > 14-days group, compared with 21 of 21 in the ≤ 14-days group. More specifically, in our study, mortality increased with each additional day on ECMO, not only during the ECMO bridge but also after transplantation, when ECMO bridge had been > 2 weeks.