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J Thorac Cardiovasc Surg 2001;122:819-820
© 2001 The American Association for Thoracic Surgery

Brief Communications

Extracorporeal membrane oxygenation for graft failure after heart transplantation: Recent Vienna experience

From the Departments of Cardio-Thoracic Surgery^a and Anesthesiology,^b General Hospital Vienna, Vienna, Austria.

Received for publication Feb 14, 2001. Accepted for publication March 8, 2001. Address for reprints: S. Taghavi, MD, General Hospital Vienna, Department of CT Surgery, Währinger Gürtel 18-20, 1090 Vienna, Austria (E-mail: taghavis@hotmail.com).

Primary graft failure in recipients of cardiac allografts is a life-threatening condition that demands implantation of an extracorporeal membrane oxygenator (ECMO) to wean these patients from cardiopulmonary bypass (CPB). In this report, we are presenting our recent experience with 6 patients who underwent ECMO insertion after primary allograft failure. We were able to wean 5 patients from ECMO. One patient died on ECMO support after retransplantation. Two other patients died of sepsis-induced multiple organ failure after successful weaning. This series suggests that ECMO implantation is feasible in overcoming primary organ failure.

No consensus has been reached on the indications for mechanical support after heart transplantation in adults having intraoperative graft failure. The literature on extracorporeal life support and primary graft failure is scarce, and information and guidelines pertaining to this life-threatening condition are limited. ^1,2 Right and left ventricular assist devices have been of moderate benefit in this critical clinical setting. ³ ECMO support is used in patients with postcardiotomy shock syndrome ⁴ or acute respiratory distress syndrome. ⁵ ECMO is currently used in our . . . [Full Text of this Article]

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