PMID- 35945148
OWN - NLM
STAT- MEDLINE
DCOM- 20220907
LR  - 20220907
IS  - 1875-2128 (Electronic)
IS  - 1875-2128 (Linking)
VI  - 115
IP  - 8-9
DP  - 2022 Aug-Sep
TI  - Outcome of primary graft dysfunction rescued by venoarterial extracorporeal 
      membrane oxygenation after heart transplantation.
PG  - 426-435
LID - S1875-2136(22)00129-2 [pii]
LID - 10.1016/j.acvd.2022.04.009 [doi]
AB  - BACKGROUND: Primary graft dysfunction remains the leading cause of 30-day 
      mortality after heart transplantation. Few data have been published about the 
      clinical outcome of severe primary graft dysfunction treated with venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO). AIM: To evaluate the prevalence 
      and outcome of severe primary graft dysfunction requiring VA-ECMO, and to 
      identify factors associated with hospital mortality. METHODS: We performed an 
      observational analysis of our institutional database of VA-ECMO for primary graft 
      dysfunction after heart transplantation. Patients with severe primary graft 
      dysfunction, according to the International Society for Heart and Lung 
      Transplantation classification, were included. The primary outcome was survival 
      to hospital discharge. Risk factors for in-hospital mortality were searched with 
      multiple logistic regression analysis using backward stepwise variable 
      elimination. RESULTS: Of the 397 patients who had heart transplantation between 
      January 2007 and December 2018, 60 (15.1%) developed severe primary graft 
      dysfunction requiring VA-ECMO. The median age was 52 (interquartile range 39-59) 
      years, and 73.3% were male. Thirty-nine (65.0%) patients were weaned after a mean 
      duration of VA-ECMO support of 7.2+/-6.0 days. Thirty-two (53.3%) patients were 
      alive at hospital discharge. Inotropic support in the recipient before heart 
      transplantation (odds ratio [OR] 3.88, 95% confidence interval [CI] 1.04-14.44; 
      P=0.04), total ischaemic time (OR 0.99, 95% CI 0.99-1.00; P=0.01) and 48-hour 
      total blood transfusion (OR 1.14, 95% CI 1.04-1.26; P=0.01) were independent 
      predictors of in-hospital mortality. CONCLUSIONS: Severe primary graft 
      dysfunction requiring VA-ECMO is frequent after heart transplantation. Survival 
      to hospital discharge after VA-ECMO for severe primary graft dysfunction is 
      satisfactory in such a critically ill population.
CI  - Copyright (c) 2022 Elsevier Masson SAS. All rights reserved.
FAU - Paulo, Nicolas
AU  - Paulo N
AD  - Department of Heart Failure and Transplantation, Hopital Cardiovasculaire Louis 
      Pradel, Hospices Civils de Lyon, 69500 Bron, France.
FAU - Prunet, Helene
AU  - Prunet H
AD  - Department of Heart Failure and Transplantation, Hopital Cardiovasculaire Louis 
      Pradel, Hospices Civils de Lyon, 69500 Bron, France.
FAU - Armoiry, Xavier
AU  - Armoiry X
AD  - Pharmacy Department, Edouard Herriot Hospital, 69002 Lyon; Laboratoire MATEIS, 
      Claude Bernard University, 69622 Villeurbanne, France.
FAU - Hugon-Vallet, Elisabeth
AU  - Hugon-Vallet E
AD  - Department of Heart Failure and Transplantation, Hopital Cardiovasculaire Louis 
      Pradel, Hospices Civils de Lyon, 69500 Bron, France.
FAU - Mocan, Raluca
AU  - Mocan R
AD  - Department of Heart Failure and Transplantation, Hopital Cardiovasculaire Louis 
      Pradel, Hospices Civils de Lyon, 69500 Bron, France.
FAU - Portran, Philippe
AU  - Portran P
AD  - Department of Anaesthesiology, Hopital Cardiovasculaire Louis Pradel, Hospices 
      Civils de Lyon, 69500 Bron, France.
FAU - Sebbag, Laurent
AU  - Sebbag L
AD  - Department of Heart Failure and Transplantation, Hopital Cardiovasculaire Louis 
      Pradel, Hospices Civils de Lyon, 69500 Bron, France.
FAU - Pozzi, Matteo
AU  - Pozzi M
AD  - Department of Cardiac Surgery, Hopital Cardiovasculaire Louis Pradel, Hospices 
      Civils de Lyon, 69500 Bron, France.
FAU - Baudry, Guillaume
AU  - Baudry G
AD  - Department of Heart Failure and Transplantation, Hopital Cardiovasculaire Louis 
      Pradel, Hospices Civils de Lyon, 69500 Bron, France. Electronic address: 
      guillaume.baudry@chu-lyon.fr.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220705
PL  - Netherlands
TA  - Arch Cardiovasc Dis
JT  - Archives of cardiovascular diseases
JID - 101465655
SB  - IM
MH  - Adult
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Female
MH  - *Heart Transplantation/adverse effects
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Primary Graft Dysfunction/diagnosis/etiology/therapy
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Extracorporeal membrane oxygenation
OT  - Heart transplantation
OT  - Inotropic support
OT  - Perioperative mortality
OT  - Primary graft dysfunction
EDAT- 2022/08/10 06:00
MHDA- 2022/09/08 06:00
CRDT- 2022/08/09 22:07
PHST- 2022/01/26 00:00 [received]
PHST- 2022/04/08 00:00 [revised]
PHST- 2022/04/11 00:00 [accepted]
PHST- 2022/08/10 06:00 [pubmed]
PHST- 2022/09/08 06:00 [medline]
PHST- 2022/08/09 22:07 [entrez]
AID - S1875-2136(22)00129-2 [pii]
AID - 10.1016/j.acvd.2022.04.009 [doi]
PST - ppublish
SO  - Arch Cardiovasc Dis. 2022 Aug-Sep;115(8-9):426-435. doi: 
      10.1016/j.acvd.2022.04.009. Epub 2022 Jul 5.