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Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure

BACKGROUND AND OBJECTIVES: Recently, approximately 40% of all heart transplantation (HTx) in South Korea are performed using the direct extracorporeal membrane oxygenation (ECMO) bridging method. We conducted a study to examine the clinical outcome of direct ECMO-bridged HTx and to investigate the i...

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Autores principales: Lim, Ji Hoon, Lee, Soo Yong, Ju, Min Ho, Kim, Seok Hyun, Choi, Jin Hee, Chon, Min Ku, Lee, Sang Hyun, Hwang, Ki Won, Kim, Jeong Su, Park, Yong Hyun, Kim, Junehong, Chun, Kook Jin, Lim, Mi Hee, Lee, Chee-hoon, Je, Hyung Gon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Heart Failure 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172075/
https://www.ncbi.nlm.nih.gov/pubmed/37180560
http://dx.doi.org/10.36628/ijhf.2023.0013
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author Lim, Ji Hoon
Lee, Soo Yong
Ju, Min Ho
Kim, Seok Hyun
Choi, Jin Hee
Chon, Min Ku
Lee, Sang Hyun
Hwang, Ki Won
Kim, Jeong Su
Park, Yong Hyun
Kim, Junehong
Chun, Kook Jin
Lim, Mi Hee
Lee, Chee-hoon
Je, Hyung Gon
author_facet Lim, Ji Hoon
Lee, Soo Yong
Ju, Min Ho
Kim, Seok Hyun
Choi, Jin Hee
Chon, Min Ku
Lee, Sang Hyun
Hwang, Ki Won
Kim, Jeong Su
Park, Yong Hyun
Kim, Junehong
Chun, Kook Jin
Lim, Mi Hee
Lee, Chee-hoon
Je, Hyung Gon
author_sort Lim, Ji Hoon
collection PubMed
description BACKGROUND AND OBJECTIVES: Recently, approximately 40% of all heart transplantation (HTx) in South Korea are performed using the direct extracorporeal membrane oxygenation (ECMO) bridging method. We conducted a study to examine the clinical outcome of direct ECMO-bridged HTx and to investigate the impact of multi-organ failure (MOF). METHODS: From June 2014 to September 2022, a total of 96 adult patients who underwent isolated HTx at a single tertiary hospital were included in the study. The patients were sub-grouped into ECMO (n=48) and non-ECMO group (n=48), and the ECMO group was subdivided into awake (n=22) and non-awake (n=26) groups based on mechanical ventilator (MV) dependency. Baseline characteristics, 30-day, and 1-year mortality were analyzed retrospectively. RESULTS: The 1-year survival rate was significantly lower in the ECMO group (72.9% vs. 95.8%, p=0.002). There was a significant difference in the 30-day survival rate between the awake and non-awake ECMO groups (81.8% vs. 65.4%, p=0.032). In the univariate analysis of logistic regression for 1-year mortality, the odds ratio was 8.5 for ECMO bridged HTx compared to the non-ECMO group, 12.3 in patients who required MV (p=0.003), and 23 with additional hemodialysis (p<0.001). CONCLUSIONS: Patients who required MV in ECMO bridged HTx showed higher preoperative MOF rates and early mortality than those extubated. When considering ECMO bridged HTx, the severity of MOF should be thoroughly investigated, and careful patient selection is necessary.
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spelling pubmed-101720752023-05-12 Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure Lim, Ji Hoon Lee, Soo Yong Ju, Min Ho Kim, Seok Hyun Choi, Jin Hee Chon, Min Ku Lee, Sang Hyun Hwang, Ki Won Kim, Jeong Su Park, Yong Hyun Kim, Junehong Chun, Kook Jin Lim, Mi Hee Lee, Chee-hoon Je, Hyung Gon Int J Heart Fail Original Article BACKGROUND AND OBJECTIVES: Recently, approximately 40% of all heart transplantation (HTx) in South Korea are performed using the direct extracorporeal membrane oxygenation (ECMO) bridging method. We conducted a study to examine the clinical outcome of direct ECMO-bridged HTx and to investigate the impact of multi-organ failure (MOF). METHODS: From June 2014 to September 2022, a total of 96 adult patients who underwent isolated HTx at a single tertiary hospital were included in the study. The patients were sub-grouped into ECMO (n=48) and non-ECMO group (n=48), and the ECMO group was subdivided into awake (n=22) and non-awake (n=26) groups based on mechanical ventilator (MV) dependency. Baseline characteristics, 30-day, and 1-year mortality were analyzed retrospectively. RESULTS: The 1-year survival rate was significantly lower in the ECMO group (72.9% vs. 95.8%, p=0.002). There was a significant difference in the 30-day survival rate between the awake and non-awake ECMO groups (81.8% vs. 65.4%, p=0.032). In the univariate analysis of logistic regression for 1-year mortality, the odds ratio was 8.5 for ECMO bridged HTx compared to the non-ECMO group, 12.3 in patients who required MV (p=0.003), and 23 with additional hemodialysis (p<0.001). CONCLUSIONS: Patients who required MV in ECMO bridged HTx showed higher preoperative MOF rates and early mortality than those extubated. When considering ECMO bridged HTx, the severity of MOF should be thoroughly investigated, and careful patient selection is necessary. Korean Society of Heart Failure 2023-04-28 /pmc/articles/PMC10172075/ /pubmed/37180560 http://dx.doi.org/10.36628/ijhf.2023.0013 Text en Copyright © 2023. Korean Society of Heart Failure https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lim, Ji Hoon
Lee, Soo Yong
Ju, Min Ho
Kim, Seok Hyun
Choi, Jin Hee
Chon, Min Ku
Lee, Sang Hyun
Hwang, Ki Won
Kim, Jeong Su
Park, Yong Hyun
Kim, Junehong
Chun, Kook Jin
Lim, Mi Hee
Lee, Chee-hoon
Je, Hyung Gon
Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure
title Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure
title_full Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure
title_fullStr Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure
title_full_unstemmed Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure
title_short Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure
title_sort direct extracorporeal membrane oxygenation bridged heart transplantation: the importance of multi-organ failure
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172075/
https://www.ncbi.nlm.nih.gov/pubmed/37180560
http://dx.doi.org/10.36628/ijhf.2023.0013
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