Original articleAdult cardiacExtracorporeal Membrane Oxygenation in Primary Graft Failure After Heart Transplantation
Section snippets
Patients and Methods
A retrospective review of prospectively collected data on 239 patients who underwent heart transplantation at our institution between January 2000 and August 2009 was performed. Orthotopic and heterotopic heart transplants, as well as heart-lung transplants, were included in this analysis. Over that time period, 54 patients developed PGF, of whom 39 patients required ECMO support. These 39 patients form the basis of this review. Institutional ethics approval was granted for this review and
Results
Two hundred thirty-nine patients underwent cardiac transplantation between January 2000 and August 2009, comprising 207 orthotopic heart transplants, 19 heterotopic heart transplants, and 13 heart lung transplants. Fifty-four patients developed PGF, of whom 39 required ECMO support (34 orthotopic heart transplants, two heterotopic heart transplants, and three heart lung transplants). In the three heart lung patients, ECMO was instituted primarily for cardiac support as per our algorithm. The
Comment
This series of heart transplant patients requiring ECMO in the immediate postoperative period for PGF represents one of the largest series published. The only published series larger is that by D'Alessandro and colleagues [7]. However, this series included patients other than those who sustained primary graft failure (personal communication); specifically it also included acute rejection patients. Our successful wean rate of 85% and survival to discharge rate of 74% also compares favorably with
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