PMID- 34988094
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220107
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 8
DP  - 2021
TI  - Veno-Arterial Extracorporeal Membrane Oxygenation for Patients Undergoing Heart 
      Transplantation: A 7-Year Experience.
PG  - 774644
LID - 10.3389/fmed.2021.774644 [doi]
LID - 774644
AB  - Objective: Primary graft dysfunction (PGD) is the leading cause of early death 
      after heart transplantation. Veno-arterial extracorporeal membrane oxygenation 
      (VA-ECMO) can provide temporary mechanical circulatory support and time for 
      functional recovery of the transplanted heart. The purpose of this study was to 
      analyze the timing and prognoses of VA-ECMO in patients with severe PGD after 
      heart transplantation. Methods: A total of 130 patients underwent heart 
      transplantation at the Zhongshan Hospital Affiliated with Fudan University 
      between January 2014 and December 2020. All patients received basiliximab 
      immunoinduction and a classic double vena cava anastomosis orthotopic heart 
      transplantation. Among them, 29 patients (22.3%) developed severe PGD in the 
      early postoperative period. VA-ECMO was performed in patients with difficulty 
      weaning from cardiopulmonary bypass (CPB) or postoperative refractory cardiogenic 
      shock. Patients were divided into two groups according to whether or not they 
      were successfully weaned from VA-ECMO (patients who survived for 48 h after 
      weaning and did not need VA-ECMO assistance again). The perioperative clinical 
      data were recorded, and all patients were followed up until discharge. Early 
      outcomes were compared between groups. Results: A total of 29 patients with 
      VA-ECMO support after heart transplantation were included in this study. The 
      proportion of patients receiving VA-ECMO was 22.3% (29/130). Nineteen patients 
      (65.5%) needed VA-ECMO due to difficulty with weaning from CPB, and 10 patients 
      required VA-ECMO for postoperative cardiogenic shock. Nineteen patients (65.5%) 
      were successfully weaned from VA-ECMO. Overall, in-hospital mortality of VA-ECMO 
      support patients was 55.2%. The main causes of death were ventricular 
      fibrillation (four cases), major bleeding (three cases), infection (four cases), 
      and graft failure (five cases). Conclusion: Despite advances in heart 
      transplantation, severe PGD remains a lethal complication after heart 
      transplantation. At present, the treatment for severe PGD after heart 
      transplantation is a challenge. VA-ECMO provides an effective treatment for 
      severe PGD after heart transplantation, which can promote graft function 
      recovery.
CI  - Copyright (c) 2021 Hou, Li, Yang, Zheng, Ma, Su, Zhang, Guo, Tu and Luo.
FAU - Hou, Jun-Yi
AU  - Hou JY
AD  - Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, 
      Shanghai, China.
FAU - Li, Xin
AU  - Li X
AD  - Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, 
      Shanghai, China.
FAU - Yang, Shou-Guo
AU  - Yang SG
AD  - Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, 
      Shanghai, China.
FAU - Zheng, Ji-Li
AU  - Zheng JL
AD  - Department of Nursing, Zhongshan Hospital, Fudan University, Shanghai, China.
FAU - Ma, Jie-Fei
AU  - Ma JF
AD  - Department of Critical Care Medicine, Xiamen Branch, Zhongshan Hospital, Fudan 
      University, Xiamen, China.
FAU - Su, Ying
AU  - Su Y
AD  - Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, 
      Shanghai, China.
FAU - Zhang, Yi-Jie
AU  - Zhang YJ
AD  - Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, 
      Shanghai, China.
FAU - Guo, Ke-Fang
AU  - Guo KF
AD  - Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, 
      China.
FAU - Tu, Guo-Wei
AU  - Tu GW
AD  - Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, 
      Shanghai, China.
FAU - Luo, Zhe
AU  - Luo Z
AD  - Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, 
      Shanghai, China.
AD  - Department of Critical Care Medicine, Xiamen Branch, Zhongshan Hospital, Fudan 
      University, Xiamen, China.
AD  - Shanghai Key Lab of Pulmonary Inflammation and Injury, Fudan University, 
      Shanghai, China.
LA  - eng
PT  - Journal Article
DEP - 20211216
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC8720851
OTO - NOTNLM
OT  - cardiogenic shock
OT  - heart failure
OT  - heart transplantation
OT  - primary graft dysfunction
OT  - veno-arterial extracorporeal membrane oxygenation
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/01/07 06:00
MHDA- 2022/01/07 06:01
PMCR- 2021/12/16
CRDT- 2022/01/06 05:59
PHST- 2021/09/12 00:00 [received]
PHST- 2021/11/18 00:00 [accepted]
PHST- 2022/01/06 05:59 [entrez]
PHST- 2022/01/07 06:00 [pubmed]
PHST- 2022/01/07 06:01 [medline]
PHST- 2021/12/16 00:00 [pmc-release]
AID - 10.3389/fmed.2021.774644 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2021 Dec 16;8:774644. doi: 10.3389/fmed.2021.774644. 
      eCollection 2021.