Extracorporeal membrane oxygenation support following liver transplantation-A case series

Clin Transplant. 2019 Jul;33(7):e13628. doi: 10.1111/ctr.13628. Epub 2019 Jun 22.

Abstract

Background: Postoperative severe cardiopulmonary failure carries a high rate of mortality. Extracorporeal membrane oxygenation (ECMO) can be used as a salvage therapy when conventional therapies fail.

Methods: We retrospectively reviewed our experience with ECMO support in the early postoperative period after liver transplant between September 2011 and May 2016.

Results: Out of 537 liver transplants performed at our institution, seven patients required ECMO support with a median age of 52 and a median MELD score of 28. Veno-venous ECMO was used in four patients with severe respiratory failure while the rest required veno-arterial ECMO for circulatory failure. The median time from transplant to cannulation was 3 days with a median duration of ECMO support of 7 days. All patients except one were successfully decannulated. The median hospital length of stay was 58 days with an in-hospital mortality of 28.6%.

Conclusion: Extracorporeal membrane oxygenation can be considered a viable rescue therapy in the setting of severe postoperative cardiopulmonary failure. Extracorporeal membrane oxygenation therapy was successful in saving patients who were otherwise unsalvageable.

Keywords: ECMO; cardiopulmonary failure; liver failure.

MeSH terms

  • Adult
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology
  • Graft Rejection / mortality
  • Graft Rejection / therapy*
  • Graft Survival
  • Heart Arrest / etiology
  • Heart Arrest / mortality
  • Heart Arrest / therapy*
  • Hospital Mortality / trends*
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / therapy*
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / mortality
  • Respiratory Insufficiency / therapy*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome