Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Support in New Era of Heart Transplant

Transpl Int. 2024 Dec 18:37:12981. doi: 10.3389/ti.2024.12981. eCollection 2024.

Abstract

Heart failure is a serious and challenging medical condition characterized by the inability of the heart to pump blood effectively, leading to reduced blood flow to organs and tissues. Several underlying causes may be linked to this, including coronary artery disease, hypertension, or previous heart attacks. Therefore, it is a chronic condition that requires ongoing management and medical attention. HF affects >64 million individuals worldwide. Heart transplantation remains the gold standard of treatment for patients with end-stage cardiomyopathy. The recruitment of marginal donors may be considered an asset at the age of cardiac donor organ shortage. Primary graft dysfunction (PGD) is becoming increasingly common in the new era of heart transplantations. PGD is the most common cause of death within 30 days of cardiac transplantation. Mechanical Circulatory Support (MCS), particularly venoarterial extracorporeal membrane oxygenation (V-A ECMO), is the only effective treatment for severe PGD. VA-ECMO support ensures organ perfusion and provides the transplanted heart with adequate rest and recovery. In the new era of heart transplantation, early use allows for increased patient survival and careful management reduces complications.

Keywords: ECMO; heart disease; heart failure; heart transplant; primary graft dysfunction.

Publication types

  • Review

MeSH terms

  • Extracorporeal Membrane Oxygenation* / methods
  • Heart Failure* / surgery
  • Heart Failure* / therapy
  • Heart Transplantation*
  • Humans
  • Primary Graft Dysfunction / therapy
  • Tissue Donors

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The study was supported by “PNRR-2022-BIOPSY_GIANT_CELL”. The funds come from the funds of the national recovery and resilience plan provided by the Ministry of Health of the Italian Republic.