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Observational Study
. 2015 Feb;19(1):68-75.
doi: 10.1111/petr.12382. Epub 2014 Oct 27.

Extracorporeal membrane oxygenation support after pediatric orthotopic heart transplantation

Jennifer A Su  1 , Robert B Kelly, Tristan Grogan, David Elashoff, Juan C Alejos
Affiliations
Observational Study

Extracorporeal membrane oxygenation support after pediatric orthotopic heart transplantation

Jennifer A Su et al. Pediatr Transplant. 2015 Feb.

Abstract

Mechanical circulatory support has been used for more than 30 yr to allow the heart to recover from ischemia and injury. There are limited pediatric data, however, on the efficacy of ECMO in the setting of post-transplantation support for primary graft dysfunction or rejection. Data from all patients at our university-affiliated, tertiary care children's hospital who underwent OHT between 1998 and 2010 and required subsequent ECMO support were analyzed. The primary outcome measure was survival to hospital discharge. Two hundred and three pediatric patients underwent OHT between 1998 and 2010 at our institution. Twenty-nine of these patients experienced post-transplantation cardiac failure requiring ECMO support, 18 of whom survived to hospital discharge (62%). Survival in the rejection and allograft vasculopathy group was 75%, and survival in patients with primary graft failure was 53% after ECMO support (p = 0.273). Patient survival to hospital discharge was not associated with ischemic time or duration of ECMO. ECMO provides hemodynamic support in the setting of cardiac failure and can be used successfully after pediatric OHT for primary graft dysfunction or rejection.

Keywords: extracorporeal membrane oxygenation; mechanical circulatory support; orthotopic heart transplantation; pediatric.

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Figures

Figure 1
Figure 1
Survival trends for post-OHT patients requiring ECMO for primary graft dysfunction versus rejection
See this image and copyright information in PMC

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