Long-term survival after pediatric cardiac transplantation and postoperative ECMO support

Kathleen N. Fenton, Steven A. Webber, David Alan Danford, Sanjiv K. Gandhi, Jayson Periera, Frank A. Pigula, Vincent K.H. Tam, Michael H. Hines

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background. Graft failure after cardiac transplantation in children can be managed acutely with mechanical support, most commonly extracorporeal membrane oxygenation (ECMO). The purpose of this study was to evaluation the long-term outcome of ECMO support early and late after pediatric cardiac transplantation. Methods. From February 1982 through October 2002, 168 patients underwent isolated cardiac transplantation. Twenty patients (11.9%) required mechanical support early or late after transplantation. Inpatient and outpatient records of these were reviewed. Results. Indication for transplantation was complex congenital heart disease in 12, cardiomyopathy in 7, and graft failure (retransplant) in 1. One patient was also on ECMO preoperatively. Fifteen patients required circulatory support immediately or shortly (less than 6 weeks) after transplantation. The remaining 5 patients were placed on ECMO for ventricular dysfunction late (3 months to 7 years) after transplantation. In the perioperative ECMO group, 8 (53%) were successfully decannulated and subsequently discharged. Three of 5 (60%) patients placed on ECMO late were successfully decannulated, 1 of whom died in hospital 10 days later and 2 of whom are still alive. Conclusions. Mechanical circulatory support using ECMO can be a useful strategy is the management of graft dysfunction after pediatric cardiac transplantation both early and late postoperatively. The mortality rate is acceptable in this very high risk group of patients and long-term outcome is good.

Original languageEnglish (US)
Pages (from-to)843-847
Number of pages5
JournalAnnals of Thoracic Surgery
Volume76
Issue number3
DOIs
StatePublished - Sep 1 2003

Fingerprint

Extracorporeal Membrane Oxygenation
Heart Transplantation
Pediatrics
Survival
Transplantation
Transplants
Ventricular Dysfunction
Cardiomyopathies
Inpatients
Heart Diseases
Outpatients
Mortality

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Fenton, K. N., Webber, S. A., Danford, D. A., Gandhi, S. K., Periera, J., Pigula, F. A., ... Hines, M. H. (2003). Long-term survival after pediatric cardiac transplantation and postoperative ECMO support. Annals of Thoracic Surgery, 76(3), 843-847. https://doi.org/10.1016/S0003-4975(03)00659-3

Long-term survival after pediatric cardiac transplantation and postoperative ECMO support. / Fenton, Kathleen N.; Webber, Steven A.; Danford, David Alan; Gandhi, Sanjiv K.; Periera, Jayson; Pigula, Frank A.; Tam, Vincent K.H.; Hines, Michael H.

In: Annals of Thoracic Surgery, Vol. 76, No. 3, 01.09.2003, p. 843-847.

Research output: Contribution to journalArticle

Fenton, KN, Webber, SA, Danford, DA, Gandhi, SK, Periera, J, Pigula, FA, Tam, VKH & Hines, MH 2003, 'Long-term survival after pediatric cardiac transplantation and postoperative ECMO support', Annals of Thoracic Surgery, vol. 76, no. 3, pp. 843-847. https://doi.org/10.1016/S0003-4975(03)00659-3
Fenton, Kathleen N. ; Webber, Steven A. ; Danford, David Alan ; Gandhi, Sanjiv K. ; Periera, Jayson ; Pigula, Frank A. ; Tam, Vincent K.H. ; Hines, Michael H. / Long-term survival after pediatric cardiac transplantation and postoperative ECMO support. In: Annals of Thoracic Surgery. 2003 ; Vol. 76, No. 3. pp. 843-847.
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abstract = "Background. Graft failure after cardiac transplantation in children can be managed acutely with mechanical support, most commonly extracorporeal membrane oxygenation (ECMO). The purpose of this study was to evaluation the long-term outcome of ECMO support early and late after pediatric cardiac transplantation. Methods. From February 1982 through October 2002, 168 patients underwent isolated cardiac transplantation. Twenty patients (11.9{\%}) required mechanical support early or late after transplantation. Inpatient and outpatient records of these were reviewed. Results. Indication for transplantation was complex congenital heart disease in 12, cardiomyopathy in 7, and graft failure (retransplant) in 1. One patient was also on ECMO preoperatively. Fifteen patients required circulatory support immediately or shortly (less than 6 weeks) after transplantation. The remaining 5 patients were placed on ECMO for ventricular dysfunction late (3 months to 7 years) after transplantation. In the perioperative ECMO group, 8 (53{\%}) were successfully decannulated and subsequently discharged. Three of 5 (60{\%}) patients placed on ECMO late were successfully decannulated, 1 of whom died in hospital 10 days later and 2 of whom are still alive. Conclusions. Mechanical circulatory support using ECMO can be a useful strategy is the management of graft dysfunction after pediatric cardiac transplantation both early and late postoperatively. The mortality rate is acceptable in this very high risk group of patients and long-term outcome is good.",
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