Expanded Efficacy of Venovenous Extracorporeal Membrane Oxygenation Support for Deceased Donor Liver Transplantation.

Abstract

BACKGROUND:

Perioperative respiratory failure occurs frequently in liver transplantation (LT) recipients. Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been applied in patients with acute and potentially reversible life-threatening respiratory failure that is unresponsive to conventional therapies. VV-ECMO is used as a bridging device for lung transplantation. However, there are few reports on VV-ECMO as bridging therapy in LT patients with respiratory failure. This study assessed patient outcomes of VV-ECMO after LT and investigated its applicability and safety in LT surgery.

METHODS:

From January 2017 to May 2019, VV-ECMO was applied in 8 deceased donor LT patients at Pusan National University Yangsan Hospital.

RESULTS:

Patients administered pre- or postoperative VV-ECMO showed a 50% 1-year survival rate and 75% success rate for ECMO weaning. Six patients were administered preoperative VV-ECMO for respiratory failure, of whom 4 patients survived for longer than a year. Two patients who received VV-ECMO for refractory hypoxia during LT died; 1 failed ECMO weaning, and the other was successfully weaned off ECMO but died of other causes.

CONCLUSION:

VV-ECMO could lower the risk of hypoxemia-related organ failure while awaiting and during LT via better controlled gas exchange without significant acute morbidity. VV-ECMO may expand operability in patients with severe respiratory failure awaiting LT.

• Authors: Soon Ji Park, Ju Yeon Park, Hyun-Su Ri, Minwoo Chung, Je Ho Ryu, Tae Beom Lee, Ji-Uk Yoon
• Journal: Transplantation proceedings (Transplant Proc) 2021 Jul-Aug Vol. 53 Issue 6 Pg. 1813-1816 ISSN: 1873-2623 [Electronic] United States
• PMID: 34016461 (Publication Type: Journal Article)
• Copyright: Copyright © 2021. Published by Elsevier Inc.

Topics

• Extracorporeal Membrane Oxygenation (adverse effects)
• Humans
• Liver Transplantation (adverse effects)
• Living Donors
• Lung Transplantation
• Respiratory Insufficiency (etiology, therapy)
• Retrospective Studies