PMID- 34962484 OWN - NLM STAT- MEDLINE DCOM- 20220203 LR - 20220203 IS - 1522-6662 (Electronic) IS - 1098-3511 (Linking) VI - 24 IP - 6 DP - 2021 Dec 14 TI - Early and Long-Term Outcomes after Direct Bridge-to-Transplantation with Extracorporeal Membrane Oxygenation. PG - E1033-E1042 LID - 10.1532/hsf.3861 [doi] AB - BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as direct bridge-to-transplantation (dBTT) remains controversial. We compared the short- and long-term outcomes of adult patients undergoing urgent heart transplantation (HT) with (dBTT) and without (non-BTT) VA-ECMO support at the time of HT. METHODS: Adults who underwent urgent HT in two institutions were assessed (N = 133; dBTT: N = 34 and non-BTT: N = 99). Patient characteristics, donor characteristics, in-hospital outcomes, and overall survival were compared. Mean follow up was 77+/-38 months and was 100% complete. Mortality predictors were identified using univariate and multivariate analyses. RESULTS: Before HT, patients with dBTT had higher rates of ischemic cardiomyopathy, acute kidney injury, liver failure, respiratory failure, and longer graft ischemia times. More patients in the dBTT group had complications, such as requiring VA-ECMO postoperatively (dBTT=50% vs. non-BTT=20%, P < 0.01). Hospital deaths (dBTT=23% vs. non-BTT=19%, P = 0.58), one-year (74% vs. 80%) and five-year survival (62% vs. 75%, P = 0.74 for overall survival) were not significantly different. The MELD-XI score and previous cardiac surgery were independent predictors of hospital mortality. CONCLUSION: Direct bridge-to-transplantation in patients on VA-ECMO support was not associated with worse long-term outcomes compared with non-VA-ECMO urgent HT, especially in recipients without any associated organ failure and a low MELD-XI score before HT. FAU - Hebert, Melanie AU - Hebert M AD - Department of Cardiac Surgery, Montreal Heart Institute - Universite de Montreal, 5000 Belanger Street, Montreal, Canada. melanie.kk.hebert@gmail.com. FAU - Noly, Pierre-Emmanuel AU - Noly PE AD - Department of Cardiac Surgery, Montreal Heart Institute - Universite de Montreal, 5000 Belanger Street, Montreal, Canada. noly.pierreemmanuel@gmail.com. FAU - Lamarche, Yoan AU - Lamarche Y AD - Department of Cardiac Surgery, Montreal Heart Institute - Universite de Montreal, 5000 Belanger Street, Montreal, Canada. yoanlamarche@gmail.com. FAU - Bouhout, Ismail AU - Bouhout I AD - Department of Cardiac Surgery, Montreal Heart Institute - Universite de Montreal, 5000 Belanger Street, Montreal, Canada. bouhout.ismail@gmail.com. FAU - Mauduit, Marion AU - Mauduit M AD - Department of Thoracic and Cardiovascular Surgery, Rennes Hospital, University of Rennes 1, 2 rue Henri Le Guilloux, 35000 Rennes, France. marion.mauduit@chu-rennes.fr. FAU - Giraldeau, Genevieve AU - Giraldeau G AD - Department of Cardiology, Montreal Heart Institute - Universite de Montreal, 5000 Belanger Street, Montreal, Canada. gen.giraldeau@gmail.com. FAU - Lelong, Bernard AU - Lelong B AD - Department of Thoracic and Cardiovascular Surgery, Rennes Hospital, University of Rennes 1, 2 rue Henri Le Guilloux, 35000 Rennes, France. bernard.lelong@chu-rennes.fr. FAU - Verhoye, Jean-Phlippe AU - Verhoye JP AD - Department of Thoracic and Cardiovascular Surgery, Rennes Hospital, University of Rennes 1, 2 rue Henri Le Guilloux, 35000 Rennes, France. jean-philippe.verhoye@univ-rennes1.fr. FAU - Carrier, Michel AU - Carrier M AD - Department of Cardiac Surgery, Montreal Heart Institute - Universite de Montreal, 5000 Belanger Street, Montreal, Canada. michel.carrier@icm-mhi.org. FAU - Flecher, Erwan AU - Flecher E AD - Department of Thoracic and Cardiovascular Surgery, Rennes Hospital, University of Rennes 1, 2 rue Henri Le Guilloux, 35000 Rennes, France. erwan.flecher@univ-rennes1.fr. LA - eng PT - Journal Article DEP - 20211214 PL - United States TA - Heart Surg Forum JT - The heart surgery forum JID - 100891112 SB - IM MH - Adult MH - Cause of Death MH - Critical Care MH - *Extracorporeal Membrane Oxygenation MH - Female MH - Heart Failure/etiology/*surgery MH - *Heart Transplantation/adverse effects MH - Hospital Mortality MH - Humans MH - Length of Stay MH - Male MH - Middle Aged MH - Postoperative Care MH - Postoperative Complications/mortality MH - Respiration, Artificial MH - Retrospective Studies MH - Treatment Outcome EDAT- 2021/12/29 06:00 MHDA- 2022/02/04 06:00 CRDT- 2021/12/28 12:11 PHST- 2021/04/01 00:00 [received] PHST- 2021/04/13 00:00 [accepted] PHST- 2021/12/28 12:11 [entrez] PHST- 2021/12/29 06:00 [pubmed] PHST- 2022/02/04 06:00 [medline] AID - 10.1532/hsf.3861 [doi] PST - epublish SO - Heart Surg Forum. 2021 Dec 14;24(6):E1033-E1042. doi: 10.1532/hsf.3861.