Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T22:58:14.111Z Has data issue: false hasContentIssue false
  • English
  • Français

Support with extracorporeal membrane oxygenation for over 1 year duration as a bridge to cardiac transplantation: a case report and review of the literature

Part of: Surgery

Published online by Cambridge University Press:  20 September 2021

Seth C. Shanefield ,
Daniel Knewitz ,
Joseph Philip ,
F. Jay Fricker ,
Kevin Sullivan ,
Circe Laucerica ,
Jeffrey P. Jacobs Open the ORCID record for Jeffrey P. Jacobs [Opens in a new window] ,
Giles J. Peek Open the ORCID record for Giles J. Peek [Opens in a new window]  and
Mark S. Bleiweis
Seth C. Shanefield
Affiliation:
University of Florida College of Medicine, Gainesville, FL, USA
Daniel Knewitz
Affiliation:
University of Florida College of Medicine, Gainesville, FL, USA
Joseph Philip
Affiliation:
Congenital Heart Center, University of Florida College of Medicine, Gainesville, FL, USA
F. Jay Fricker
Affiliation:
Congenital Heart Center, University of Florida College of Medicine, Gainesville, FL, USA
Kevin Sullivan
Affiliation:
Congenital Heart Center, University of Florida College of Medicine, Gainesville, FL, USA
Circe Laucerica
Affiliation:
Congenital Heart Center, University of Florida College of Medicine, Gainesville, FL, USA
Jeffrey P. Jacobs
Affiliation:
Congenital Heart Center, University of Florida College of Medicine, Gainesville, FL, USA
Giles J. Peek
Affiliation:
Congenital Heart Center, University of Florida College of Medicine, Gainesville, FL, USA
Mark S. Bleiweis*
Affiliation:
Congenital Heart Center, University of Florida College of Medicine, Gainesville, FL, USA
*
Author for correspondence: M. S. Bleiweis, MD, Congenital Heart Center, UF Health Shands Hospital, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville, FL 32608, USA. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

We present the case of a 13-year-old male with a complex congenital cardiac history who was supported with extracorporeal membrane oxygenation for 394 days while awaiting cardiac transplantation. The patient underwent successful cardiac transplantation after 394 days of support with veno-arterial extracorporeal membrane oxygenation and is currently alive 2 years after cardiac transplantation. We believe that this case represents the longest period of time that a patient has been supported with extracorporeal membrane oxygenation as a bridge to cardiac transplantation.

We also review the literature associated with prolonged support with extracorporeal membrane oxygenation. This case report documents many of the challenges associated with prolonged support with extracorporeal membrane oxygenation, including polymicrobial bacterial and fungal infections, as well as renal dysfunction. It is possible to successfully bridge a patient to cardiac transplantation with prolonged support with extracorporeal membrane oxygenation of over 1 year; however, multidisciplinary collaboration is critical.

Keywords

ECMOrenal failureinfectionheart transplantation
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 9 , September 2021 , pp. 1495 - 1497
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almond, CS, Singh, TP, Gauvreau, K, et al. Extracorporeal membrane oxygenation for bridge to heart transplantation among children in the United States: analysis of data from the Organ Procurement and Transplant Network and Extracorporeal Life Support Organization Registry. Circulation 2011; 123: 2975–2984.CrossRefGoogle ScholarPubMed
Punn, R, Axelrod, DM, Sherman-Levine, S, Roth, SJ, Tacy, TA. Predictors of mortality in pediatric patients on venoarterial extracorporeal membrane oxygenation. Pediatr Crit Care Med 2014; 15: 870–877.CrossRefGoogle ScholarPubMed
Kolovos, N, Bratton, S, Moler, F, et al. Outcome of pediatric patients treated with extracorporeal life support after cardiac surgery. Ann Thorac Surg 2003; 76: 1435–1441.CrossRefGoogle ScholarPubMed
Duncan, B, Hraska, V, Jonas, R, et al. Mechanical circulatory support in children with cardiac disease. J Thorac Cardiovasc Surg 1999; 117: 529–542.CrossRefGoogle ScholarPubMed
Wu, MY, Lin, PJ, Tsai, FC, Haung, YK, Liu, KS, Tsai, FC. Impact of preexisting organ dysfunction on extracorporeal life support for non-postcardiotomy cardiopulmonary failure. Resuscitation 2008; 79: 54–60.CrossRefGoogle ScholarPubMed
Montgomery, V, Strotman, J, Ross, M. Impact of multiple organ system dysfunction and nosocomial infections on survival of children treated with extracorporeal membrane oxygenation after heart surgery. Crit Care Med 2000; 28: 526–531.CrossRefGoogle ScholarPubMed
Shah, SM, Kays, DW, Ghazarian, SR, et al. Eighteen years of paediatric extracorporeal membrane oxygenation and ventricular assist devices: insight regarding late outcomes. Cardiol Young 2018; 28: 1316–1322. DOI 10.1017/S1047951118001282.CrossRefGoogle ScholarPubMed
Di Russo, GB, Clark, BJ, Bridges, ND, et al. Prolonged extracorporeal membrane oxygenation as a bridge to cardiac transplantation. Ann Thorac Surg 2000; 69: 925–927. DOI 10.1016/s0003-4975(99)01362-4.CrossRefGoogle ScholarPubMed
Gupta, P, McDonald, R, Chipman, C, et al. 20-Year experience of prolonged extracorporeal membrane oxygenation in critically ill children with cardiac or pulmonary failure. Ann Thorac Surg 2012; 93: 1584–1591.CrossRefGoogle ScholarPubMed
Nelson-McMillan, K, Vricella, LA, Stewart, FD, et al. Recovery from total acute lung failure after 20 months of extracorporeal life support. ASAIO J 2020; 66: e11–e14. DOI 10.1097/MAT.0000000000000990.CrossRefGoogle ScholarPubMed
Cashen, K, Reeder, R, Dalton, HJ, et al. Acquired infection during neonatal and pediatric extracorporeal membrane oxygenation. Perfusion 2018; 33: 472–482.CrossRefGoogle ScholarPubMed