Comparison between survivors and nonsurvivors among patients who received VA-ECMO
| Characteristic | No. (%) of patients* | p value | |
|---|---|---|---|
| Survivors n = 28 | Nonsurvivors n = 38 | ||
| 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 |
GFR = glomerular filtration rate; ICU = intensive care unit; MDRD = Modification of Diet in Renal Disease study equation; MELD-XI = Model for End-stage Liver Disease score excluding INR; RADIAL = right atrial pressure ≥ 10 mm Hg, recipient age ≥ 60 yr, diabetes mellitus, inotrope dependence, donor age ≥ 30 yr, length of ischemic time ≥ 240 min; SD = standard deviation; VA-ECMO = venoarterial extracorporeal membrane oxygenation.
↵* Unless indicated otherwise.