- Poster presentation
- Published:
Extracorporeal membrane oxygenation before and after adult liver transplantation: worth the effort?
Critical Care volume 18, Article number: P203 (2014)
Introduction
Extracorporeal membrane oxygenation (ECMO) is increasingly used for the treatment of refractory but potentially reversible respiratory and/or cardiac failure. Data on perioperative support with veno-arterial (V-A) and veno-venous (V-V) ECMO for adult liver transplant recipients are scarce [1, 2].We report our experience of ECMO support in patients with acute liver failure (ALF) as a bridge to transplant and postoperative ECMO use following complications after surgery.
Methods
A retrospective study in a specialist tertiary referral ICU. Patients supported with V-V or V-A ECMO before, during, or after orthotopic liver transplant (OLT) were identified.
Results
In total, four patients were supported during a 12-month period. Two patients required V-V and two patients V-A support. Two patients with ALF were bridged to OLT, one patient V-V ECMO for refractory respiratory failure and the other patient required emergency V-A support for treatment of intraoperative arrest. Both patients were successfully transplanted but died subsequently on ECMO: disseminated aspergillosis and haemophagocytic syndrome, and anoxic brain injury respectively. Two patients received postoperative ECMO support. The first was treated with V-V ECMO for refractory persistent hypoxaemia following OLT for hepato-pulmonary syndrome, the second received emergency V-A support (eCPR) following cardiac tamponade and arrest on postoperative day 2. Both patients made a full recovery.
Conclusion
Emergency ECMO support before and after liver transplant is feasible. Despite the poor outcome in patients with ALF, we consider ECMO a valuable option to bridge selected patients to transplant.
References
Choi NK, et al.: Hepatogastroenterology. 2012, 59 1189-1193.
Monsel A, et al.: Crit Care. 2011, 15: R234. 10.1186/cc10476
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Auzinger, G., Willars, C., Loveridge, R. et al. Extracorporeal membrane oxygenation before and after adult liver transplantation: worth the effort?. Crit Care 18 (Suppl 1), P203 (2014). https://doi.org/10.1186/cc13393
Published:
DOI: https://doi.org/10.1186/cc13393