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Extracorporeal Membrane Oxygenation Can Save Lives in Children With Heart or Lung Failure After Liver Transplantation
Author(s) -
Jean Sandrine,
Chardot Christophe,
Oualha Mehdi,
Capito Carmen,
Bustarret Olivier,
Pouard Philippe,
Renolleau Sylvain,
Lacaille Florence,
Dupic Laurent
Publication year - 2017
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12975
Subject(s) - medicine , extracorporeal membrane oxygenation , inotrope , respiratory failure , extracorporeal , heart failure , mechanical ventilation , lung , transplantation , oxygenation , lung transplantation , liver transplantation , intensive care , cardiology , intensive care medicine
The risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life‐saving. Four children with either acute pulmonary (three) or cardiac (one) failure after LT, and the criteria that decided the use of ECMO (level of ventilation and results, dosage of inotropic drugs, cardiac ultrasound, blood lactate) were retrospectively reported. These patients, 1–11 years old, were treated with either veno‐arterial (three) or veno‐venous (one) ECMO. Two experienced a full recovery, with 3 and 6 years of follow‐up. Two died of systemic inflammatory response syndrome (SIRS) due to ECMO, and relapse of heart failure due to the underlying disease. Although our patients' survival was only 50%, we showed that ECMO can be useful in children after LT. It should be considered before the development of irreversible multiorgan failure.