PMID- 35340846
OWN - NLM
STAT- MEDLINE
DCOM- 20220506
LR  - 20220506
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Print)
IS  - 0934-0874 (Linking)
VI  - 35
DP  - 2022
TI  - Post-Transplant Extracorporeal Membrane Oxygenation for Severe Primary Graft 
      Dysfunction to Support the Use of Marginal Donor Hearts.
PG  - 10176
LID - 10.3389/ti.2022.10176 [doi]
LID - 10176
AB  - Severe primary graft dysfunction (PGD) is the leading cause of early 
      postoperative mortality following orthotopic heart transplantation (OHT). 
      Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used as 
      salvage therapy. This study aimed to evaluate the outcomes in adult OHT 
      recipients who underwent VA-ECMO for severe PGD. We retrospectively reviewed 899 
      adult (>/=18 years) patients who underwent primary OHT at our institution between 
      1997 and 2017. Recipients treated with VA-ECMO (19, 2.1%) exhibited a higher 
      incidence of previous cardiac surgery (p = .0220), chronic obstructive pulmonary 
      disease (p = .0352), and treatment with a calcium channel blocker (p = .0018) and 
      amiodarone (p = .0148). Cardiopulmonary bypass (p = .0410) and aortic cross-clamp 
      times (p = .0477) were longer in the VA-ECMO cohort and they were more likely to 
      have received postoperative transfusion (p = .0013); intra-aortic balloon pump 
      (IABP, p < .0001), and reoperation for bleeding or tamponade (p < .0001). The 
      30-day, 1-year, and overall survival after transplantation of non-ECMO patients 
      were 95.9, 88.8, and 67.4%, respectively, compared to 73.7, 57.9, and 47.4%, 
      respectively in the ECMO cohort. Fourteen (73.7%) of the ECMO patients were 
      weaned after a median of 7 days following OHT (range: 1-12 days). Following OHT, 
      VA-ECMO may be a useful salvage therapy for severe PGD and can potentially 
      support the usage of marginal donor hearts.
CI  - Copyright (c) 2022 Shudo, Alassar, Wang, Lingala, He, Zhu, Hiesinger, MacArthur, 
      Boyd, Lee, Currie and Woo.
FAU - Shudo, Yasuhiro
AU  - Shudo Y
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Alassar, Aiman
AU  - Alassar A
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Wang, Hanjay
AU  - Wang H
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Lingala, Bharathi
AU  - Lingala B
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - He, Hao
AU  - He H
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Zhu, Yuanjia
AU  - Zhu Y
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Hiesinger, William
AU  - Hiesinger W
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - MacArthur, John W
AU  - MacArthur JW
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Boyd, Jack H
AU  - Boyd JH
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Lee, Anson M
AU  - Lee AM
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Currie, Maria
AU  - Currie M
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
FAU - Woo, Y Joseph
AU  - Woo YJ
AD  - Department of Cardiothoracic Surgery, Stanford University School of Medicine, 
      Stanford, CA, United States.
LA  - eng
PT  - Journal Article
DEP - 20220310
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
SB  - IM
MH  - Adult
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - *Heart Transplantation/adverse effects
MH  - Humans
MH  - *Primary Graft Dysfunction/epidemiology/etiology/therapy
MH  - Retrospective Studies
MH  - Tissue Donors
PMC - PMC8943911
OTO - NOTNLM
OT  - ECMO
OT  - heart transplantation
OT  - marginal donor heart
OT  - outcomes
OT  - primary graft dysfunction
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- 2022/03/29 06:00
MHDA- 2022/05/07 06:00
PMCR- 2022/03/10
CRDT- 2022/03/28 05:17
PHST- 2021/11/02 00:00 [received]
PHST- 2022/01/18 00:00 [accepted]
PHST- 2022/03/28 05:17 [entrez]
PHST- 2022/03/29 06:00 [pubmed]
PHST- 2022/05/07 06:00 [medline]
PHST- 2022/03/10 00:00 [pmc-release]
AID - 10176 [pii]
AID - 10.3389/ti.2022.10176 [doi]
PST - epublish
SO  - Transpl Int. 2022 Mar 10;35:10176. doi: 10.3389/ti.2022.10176. eCollection 2022.