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Intensive pulmonary support using extracorporeal membrane oxygenation in adult patients undergoing liver transplantation.
MedLine Citation:
PMID:  22580672     Owner:  NLM     Status:  In-Data-Review    
Background/Aims: Adult liver transplantation (LT) recipients occasionally show serious acute cardiopulmonary dysfunction, requiring intensive care. We have assessed the feasibility of extracorporeal membrane oxygenation (ECMO) support in adult LT recipients facing acute pulmonary failure and refractory to conventional mechanical ventilation and concurrent nitric oxide gas inhalation. Methodology: From January 2008 to June 2009, 9 adult LT recipients required ECMO support due to pneumonia (n=5) and adult respiratory distress syndrome (n=4). Mean age was 52.6±5.9 years and mean model for end-stage liver disease score was 29.0±7.5. Five patients underwent living-donor LT and four underwent deceased-donor LT. Results: Veno-venous access mode was used and continuous veno-venous hemodiafiltration was performed concurrently in all 9 patients. No procedurerelated complications occurred. Successful ECMO weaning was achieved in 4 patients (44.4%) at the first attempt, after mean ECMO support of 12.0±6.8 days but the other five died due to overwhelming infection prior to ECMO weaning. Univariate analysis revealed no significant risk factors for failing ECMO support before ECMO start. Conclusions: ECMO as rescue therapy seems beneficial to be considered as a final therapeutic option for LT recipients with refractory pulmonary dysfunction who would otherwise die due to hypoxemia.
Nam-Kyu Choi; Shin Hwang; Kwan-Woo Kim; Gil-Chun Park; Young-Dong Yu; Sung-Ho Jung; Pyung-Jae Park; Young-Il Choi; Gi-Won Song; Dong-Hwan Jung; Suk-Kyung Hong; Chul-Soo Ahn; Ki-Hun Kim; Deok-Bog Moon; Tae-Yong Ha; Sung-Gyu Lee
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  59     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2012 Jul-Aug
Date Detail:
Created Date:  2012-05-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1189-93     Citation Subset:  IM    
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