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Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome

Although patients receiving extracorporeal life support (ECLS) as a bridge to transplantation have demonstrated worse outcomes than those without ECLS, we investigated the key factors in the improvement of their posttransplant outcome. From December 2003 to December 2018, 257 adult patients who unde...

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Autores principales: Lee, Jun Ho, Choi, Nayeon, Kim, Yun Jin, Sung, Kiick, Kim, Wook Sung, Kim, Darae, Yang, Jeong Hoon, Jeon, Eun-Seok, Shinn, Sung Ho, Choi, Jin-Oh, Cho, Yang Hyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228810/
https://www.ncbi.nlm.nih.gov/pubmed/34201305
http://dx.doi.org/10.3390/jcm10122542
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author Lee, Jun Ho
Choi, Nayeon
Kim, Yun Jin
Sung, Kiick
Kim, Wook Sung
Kim, Darae
Yang, Jeong Hoon
Jeon, Eun-Seok
Shinn, Sung Ho
Choi, Jin-Oh
Cho, Yang Hyun
author_facet Lee, Jun Ho
Choi, Nayeon
Kim, Yun Jin
Sung, Kiick
Kim, Wook Sung
Kim, Darae
Yang, Jeong Hoon
Jeon, Eun-Seok
Shinn, Sung Ho
Choi, Jin-Oh
Cho, Yang Hyun
author_sort Lee, Jun Ho
collection PubMed
description Although patients receiving extracorporeal life support (ECLS) as a bridge to transplantation have demonstrated worse outcomes than those without ECLS, we investigated the key factors in the improvement of their posttransplant outcome. From December 2003 to December 2018, 257 adult patients who underwent heart transplantation (HTx) at our institution were included. We identified 100 patients (38.9%) who underwent HTx during ECLS (ECLS group). The primary outcome was 30-day mortality after HTx. The median duration of ECLS was 10.0 days. The 30-day mortality rate was 3.9% (9.2% in peripheral ECLS, 2.9% in central ECLS, and 1.9% in non-ECLS). The use of ECLS was not an independent predictor of 30-day and 1-year mortality (p = 0.248 and p = 0.882, respectively). Independent predictors of 30-day mortality were found to be higher ejection fraction (p < 0.001), Sequential Organ Failure Assessment score (p < 0.001), and total bilirubin level (p = 0.005). In a subgroup analysis, cannulation type was not a predictor of 30-day mortality (p = 0.275). Early ECLS application to prevent organ failure and sophisticated management of acute heart failure may be important steps in achieving favorable survival after HTx.
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spelling pubmed-82288102021-06-26 Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome Lee, Jun Ho Choi, Nayeon Kim, Yun Jin Sung, Kiick Kim, Wook Sung Kim, Darae Yang, Jeong Hoon Jeon, Eun-Seok Shinn, Sung Ho Choi, Jin-Oh Cho, Yang Hyun J Clin Med Article Although patients receiving extracorporeal life support (ECLS) as a bridge to transplantation have demonstrated worse outcomes than those without ECLS, we investigated the key factors in the improvement of their posttransplant outcome. From December 2003 to December 2018, 257 adult patients who underwent heart transplantation (HTx) at our institution were included. We identified 100 patients (38.9%) who underwent HTx during ECLS (ECLS group). The primary outcome was 30-day mortality after HTx. The median duration of ECLS was 10.0 days. The 30-day mortality rate was 3.9% (9.2% in peripheral ECLS, 2.9% in central ECLS, and 1.9% in non-ECLS). The use of ECLS was not an independent predictor of 30-day and 1-year mortality (p = 0.248 and p = 0.882, respectively). Independent predictors of 30-day mortality were found to be higher ejection fraction (p < 0.001), Sequential Organ Failure Assessment score (p < 0.001), and total bilirubin level (p = 0.005). In a subgroup analysis, cannulation type was not a predictor of 30-day mortality (p = 0.275). Early ECLS application to prevent organ failure and sophisticated management of acute heart failure may be important steps in achieving favorable survival after HTx. MDPI 2021-06-08 /pmc/articles/PMC8228810/ /pubmed/34201305 http://dx.doi.org/10.3390/jcm10122542 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Jun Ho
Choi, Nayeon
Kim, Yun Jin
Sung, Kiick
Kim, Wook Sung
Kim, Darae
Yang, Jeong Hoon
Jeon, Eun-Seok
Shinn, Sung Ho
Choi, Jin-Oh
Cho, Yang Hyun
Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome
title Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome
title_full Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome
title_fullStr Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome
title_full_unstemmed Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome
title_short Use of Extracorporeal Life Support for Heart Transplantation: Key Factors to Improve Outcome
title_sort use of extracorporeal life support for heart transplantation: key factors to improve outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228810/
https://www.ncbi.nlm.nih.gov/pubmed/34201305
http://dx.doi.org/10.3390/jcm10122542
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