Central ECMO for circulatory failure following pediatric liver transplantation

Scott, John; Hong, Johnny C.; Thompson, Nathan E.; Woods, Ronald K.; Hoffman, George M.

doi:10.1177/0267659118778170

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…In 3 pediatric liver recipients, they developed graft failure and pulmonary failure after the first LT, supported by ECMO for a few days, and got retransplantation. [ 12 , 14 , 15 ] Only 1 patient who suffered from acute respiratory distress syndrome clearly underwent ECMO before LT (13 days). [ 16 ] Our case is the first case using ECMO as a measure to prevent cardiocirculatory failure in LT.…”

Section: Discussionmentioning

confidence: 99%

Utilization of extracorporeal membrane oxygenation for a severe cardiocirculatory dysfunction recipient in liver transplantation

et al. 2018

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Rationale:Severe cardiac dysfunction or severe pulmonary hypertension is a contraindication of liver transplantation (LT). Extracorporeal membrane oxygenation (ECMO) is an advanced therapy for severe lung and/or cardiocirculatory dysfunction or failure. The application of ECMO to patients during the LT perioperative period may help recipients with severe cardiac disease to maintain the heart function and alleviate the reperfusion syndrome.Patient concerns:A female liver recipient complained about weakness for 6 months.Diagnoses:The patient was diagnosed as hepatitis B virus (HBV)-related hepatic cirrhosis (MELD 24, Child–Pugh C) with severe mitral regurgitation, severe tricuspid regurgitation, left atrium and left ventricle enlargement, cardiac insufficiency, pulmonary arterial hypertension, and hypoxemia.Interventions:The patient underwent LT from a cardiac deceased donor. The surgery was completed by venoarterial ECMO. The femoral vessels cannulation was done after the dissection of the patient's liver and before the venous blocking. Venous cannula reached to the position below renal vein, while arterial cannula reached to common iliac artery. We regulated the ECMO index according to the patient's condition. The dosage of heparin was adjusted on the basis of the activated clotting time. Respiratory support, milrinone, furosemide, and mannitol were used to improve the circulation. The bleeding volume of surgery was 1200 mL. The cardiocirculatory function and other vital signs remained good in the perioperative period. In the first 24 hours after surgery, central venous pressure decreased from 17 to 7 cmH2O. Thirty hours after surgery, the ECMO was removed. Eighteen hours later, the recipient did not need respiratory support.Outcomes:No complications of transplantation or ECMO were found.Lessons:It is feasible to utilize ECMO as a cardiocirculatory function support in the LT. ECMO does not increase the risk of hemorrhage. ECMO can play an important role in ensuring the security of the liver recipients in the surgery and in the postoperative period.

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Section: Discussionmentioning

confidence: 99%

Utilization of extracorporeal membrane oxygenation for a severe cardiocirculatory dysfunction recipient in liver transplantation

et al. 2018

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“…Furthermore, in 2018, Scott et al [42] also reported on a pediatric case. Specifically, after undergoing a liver transplant, the pediatric patient developed post-transplant liver dysfunction (hyperbilirubinemia and coagulation dysfunction) and RSS.…”

Section: Application Of Ecmo To the Treatment Of Rss Post-transplant ...mentioning

confidence: 99%

Extracorporeal membrane oxygenation for refractory septic shock in children

2024

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Children are susceptible to developing sepsis. Among its complications, septic shock is the most severe. Refractory septic shock (RSS) is defined as septic shock that is unresponsive to standard resuscitation. As the most severe complication of sepsis in children, refractory septic shock (RSS) is characterized by its rapid development and high mortality rate. In accordance with relevant guidelines and consensus, extracorporeal membrane oxygenation (ECMO) is recommended as a salvage therapy for the treatment of RSS in children. However, various controversies and difficulties still exists when ECMO is used to treat children with RSS. Thus, this review summarizes the current status, difficulties, and explorations of applying ECMO to the treatment of RSS in children.

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“…From 24 articles initially identified as potentially eligible, 16 studies were retrieved for data extraction after fulltext review (Figure 2). The studies included in the present systematic review were published between 2000 and 2020 and were conducted in the United States (n = 7), 8,9,[18][19][20][21][22] Asia (n = 5), 7,12,[23][24][25] Europe (n = 3), [4][5][6] and Canada (n = 1). 26 A total of 22 children that received ECMO on the day of transplant or later were included in the systematic review (Table 4).…”

Section: Systematic Review Of the Literaturementioning

confidence: 99%