INTRODUCTION:

Acute graft failure is the leading cause of early mortality after heart transplantation (HTX). Extracorporeal membrane oxygenation (ECMO) is a therapy option to treat heart failure or to allow the transplanted heart to recover function. We reviewed our ECMO experience and outcome in HTX patients.

METHODS:

The aim of the study was to evaluate the clinical outcome, 30 day- and longterm follow up in patients undergoing extracorperal membrane oxygenation (ECMO) after HTX and refractory postcardiotomy cardiogenic shock at our high volume tertiary care center. We analyzed all patients undergoing HTX in our department between 1997 and November 2017. From this patients an ECMO therapy was necessary in 59 pts. (13.7%; age: 45.9±14 years; 81.4% male). Follow-up range was from 0 to 11.5 years and was complete in 100%.

RESULTS:

Patient mean body mass index was 26.7±4.0 kg/m[sup2], diabetes in 21.4%, arterially hypertension in 45.8%, pulmonary hypertension in 10.2%, history of smoking in 27.1%, chronic obstructive pulmonary disease in 1.7%, peripheral arterial disease in 8.5%, preoperative stroke in 1.7%, preoperative dialysis was in 5.1%, previous operation in 45.5% and preoperative ejection fraction of 23.5±8.9%. Mean support time was 6.3 ± 4.6 days. 30 day survival rate was 59.0±6.4%, 5 year survival rate was 34.7±7.1% and 17.4±7.9% after 10 years. Patients who were discharged from hospital had a 5 year survival rate of 63.2%±10.4% and 10 year survival rate of 31.6±10.9%. As complication we find a bleeding event in 62.7% with 56.4±51 packed red blood cells and 41.2±41 FFP, postoperative dialysis in 54.2%, tracheotomy in 30.5%, sepsis in 15.3%, deep wound infection in 6.8%, gastrointestinal complication in 27.1% and stroke in 6.8%.

CONCLUSION:

ECMO support as a last resort for postoperative output failure offers an acceptable perspective to otherwise doomed patients with graft failure after HTX.

CITATION INFORMATION: Lehmann S., Jawad K., Feder S., Meyer A., Dieterlen M., Fischer J., Garbade J., Borger M. Extracorporeal Membrane Oxygenation Experience for Graft Failure after Heart Transplantation Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress