Pretransplantation characteristics |
Age, yr, mean ± SD | 49 ± 13 | 48 ± 12 | 0.65 |
Emergent heart transplantation | 5 (18) | 16 (42) | 0.03 |
Highly sensitized (panel reactive antibody > 80%) | 6 (21) | 5 (13) | 0.37 |
Chronic kidney failure (GFR < 60 mL/min in MDRD) | 7 (25) | 12 (32) | 0.56 |
Previous sternotomy | 10 (35) | 14 (37) | 0.92 |
In ICU at the time of transplantation | 4 (15) | 13 (34) | 0.08 |
Waiting time, d, mean ± SD | 230 ± 285 | 124 ± 142 | 0.05 |
Acute kidney failure (GFR < 40 ml/min in MDRD) | 5 (18) | 7 (19) | 0.91 |
Acute liver failure (bilirubin > 30 μmol/L) | 1 (4) | 10 (26) | 0.01 |
Low cardiac output syndrome | 6 (22) | 17 (46) | 0.05 |
Mean pulmonary arterial pressure, mm Hg, mean ± SD | 34 ± 10 | 26 ± 11 | 0.008 |
GFR, mL/min, mean ± SD | 70 ± 29 | 63 ± 23 | 0.26 |
Pulmonary vascular resistance, Wood units, mean ± SD | 2.38 ± 1.1 | 2.39 ± 1.4 | 0.97 |
Total bilirubin, mg/dL, mean ± SD | 16 ± 8 | 19 ± 11 | 0.33 |
Inotropic support (any catecholamine) | 6 (21) | 9 (24) | 0.82 |
MELD-XI score, mean ± SD | 10.1 ± 4.0 | 12.8 ± 4.4 | 0.16 |
RADIAL score, mean ± SD | 1.6 ± 0.9 | 1.9 ± 0.9 | 0.31 |
Ischemia time, mean ± SD | 199 ± 62 | 201 ± 72 | 0.92 |
Indications for ECMO (nonexclusive) |
Primary graft dysfunction |
Left ventricle | 4 (14) | 4 (10) | 0.64 |
Right ventricle | 13 (46) | 20 (53) | 0.61 |
Biventricular | 5 (18) | 10 (26) | 0.46 |
Secondary graft dysfunction |
Right ventricle failure due to pulmonary hypertension | 10 (36) | 10 (26) | 0.41 |
Cardiac arrest | 0 | 8 (35) | 0.05 |
Patient characteristics before VA-ECMO |
Maximum noradrenaline dose, μg/kg per min, mean ± SD | 0.75 ± 1.9 | 0.87 ± 1.8 | 0.85 |
Maximum adrenaline dose, μg/kg per min, mean ± SD | 0.22 ± 0.21 | 0.48 ± 0.6 | 0.08 |
Inotrope duration, mean ± SD | 15 ± 16 | 8 ± 7 | 0.06 |
Peak of serum lactates, mmol/L, mean ± SD | 13 ± 4 | 15 ± 6 | 0.48 |
Delayed initiation of VA-ECMO | 4 (14) | 22 (58) | 0.001 |
Technical considerations |
Peripheral | 27 (96) | 26 (68) | 0.005 |
Conversion from peripheral to central | 1 (4) | 4 (10) | 0.25 |
Central | 1 (4) | 16 (42) | 0.001 |
Complications under VA-ECMO |
Reoperation for bleeding or tamponade | 17 (60) | 25 (67) | 0.56 |
Lower limb ischemia | 2 (7) | 6 (16) | 0.27 |
Bleeding requiring blood transfusions | 13 (48) | 23 (60) | 0.32 |
24-h bleeding, mean ± SD | 1279 ± 944 | 2350 ± 270 | 0.03 |
Recipient-donor match |
Mismatch weight > 20% | 9 (32) | 9 (23) | 0.44 |
Mismatch sex | | | |
Recipient man, donor woman | 2 (7) | 4 (10) | 0.63 |
Recipient woman, donor man | 4 (14) | 5 (13) | 0.89 |