PMID- 30870577
OWN - NLM
STAT- MEDLINE
DCOM- 20200804
LR  - 20200804
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 33
IP  - 5
DP  - 2019 May
TI  - Extracorporeal membrane oxygenation as a salvage therapy for patients with severe 
      primary graft dysfunction after heart transplant.
PG  - e13538
LID - 10.1111/ctr.13538 [doi]
AB  - BACKGROUND: Severe primary graft dysfunction (PGD) is the leading cause of early 
      death after heart transplant. AIM: To examine the outcomes of heart transplant 
      recipients who received venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) for severe PGD. METHODS: We reviewed electronic health records of adult 
      patients who underwent heart transplant from November 2005 through June 2015. We 
      defined severe PGD according to International Society for Heart and Lung 
      Transplantation consensus statements. RESULTS: Of 1030 heart transplant patients, 
      31 (3%) had severe PGD and required VA-ECMO. The mean (range) age was 59 (43-69) 
      years. Fifteen patients (48%) underwent prior sternotomy and 10 (32%) received a 
      left ventricular assist device as a bridge to transplant. Severe PGD manifested 
      as failure to wean from cardiopulmonary bypass in 20 patients (65%) and as severe 
      hemodynamic instability in the immediate postoperative period in 10 (32%), 
      including cardiac arrest in 3 (10%). Twenty-five patients (81%) were successfully 
      weaned from VA-ECMO, and 19 (61%) were discharged; the other 12 (39%) died. 
      CONCLUSIONS: Although VA-ECMO is a common method for providing mechanical 
      circulatory support to patients with PGD, multicenter studies are needed to 
      assess factors associated with successful outcomes and improved survival of these 
      patients.
CI  - (c) 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Jacob, Samuel
AU  - Jacob S
AD  - Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
FAU - Lima, Brian
AU  - Lima B
AD  - Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, 
      Texas.
FAU - Gonzalez-Stawinski, Gonzalo V
AU  - Gonzalez-Stawinski GV
AD  - Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, 
      Texas.
FAU - El-Sayed Ahmed, Magdy M
AU  - El-Sayed Ahmed MM
AD  - Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
AD  - Department of Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
FAU - Patel, Parag C
AU  - Patel PC
AD  - Division of Transplant Medicine, Mayo Clinic, Jacksonville, Florida.
FAU - Belli, Erol V
AU  - Belli EV
AD  - Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
FAU - Makey, Ian A
AU  - Makey IA
AD  - Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
FAU - Thomas, Mathew
AU  - Thomas M
AD  - Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
FAU - Landolfo, Kevin
AU  - Landolfo K
AD  - Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
FAU - Landolfo, Carolyn
AU  - Landolfo C
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida.
FAU - Leoni Moreno, Juan Carlos
AU  - Leoni Moreno JC
AD  - Division of Transplant Medicine, Mayo Clinic, Jacksonville, Florida.
FAU - Yip, Daniel S
AU  - Yip DS
AD  - Division of Transplant Medicine, Mayo Clinic, Jacksonville, Florida.
FAU - Pham, Si M
AU  - Pham SM
AD  - Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
LA  - eng
PT  - Journal Article
DEP - 20190414
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
SB  - IM
MH  - Adult
MH  - Aged
MH  - Extracorporeal Membrane Oxygenation/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/etiology/pathology/*therapy
MH  - Graft Survival
MH  - Heart Diseases/*surgery
MH  - Heart Transplantation/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/etiology/pathology/*therapy
MH  - Primary Graft Dysfunction/etiology/pathology/*therapy
MH  - Prognosis
MH  - Risk Factors
MH  - *Salvage Therapy
OTO - NOTNLM
OT  - clinical
OT  - extracorporeal membrane oxygenation
OT  - heart/ventricular assist devices
OT  - organ procurement and transplantation
EDAT- 2019/03/15 06:00
MHDA- 2020/08/05 06:00
CRDT- 2019/03/15 06:00
PHST- 2018/10/22 00:00 [received]
PHST- 2019/02/27 00:00 [revised]
PHST- 2019/03/09 00:00 [accepted]
PHST- 2019/03/15 06:00 [pubmed]
PHST- 2020/08/05 06:00 [medline]
PHST- 2019/03/15 06:00 [entrez]
AID - 10.1111/ctr.13538 [doi]
PST - ppublish
SO  - Clin Transplant. 2019 May;33(5):e13538. doi: 10.1111/ctr.13538. Epub 2019 Apr 14.