Abstract
Purpose Extracorporeal membrane oxygenation (ECMO) is the primary indication for transplanted right heart failure in transition and postoperative period for heart transplantation patients. This study explored risk factors affecting the clinical prognosis of ECMO through analyzing the clinical data of heart transplantation patients with such condition. Methods Data on 28 heart transplantation patients with ECMO obtained from January 2012 to January 2018 in the People’s Hospital of Zhongshan City were retrospectively analyzed. Results A total of 25 patients (20 male and 5 female) were included in this study. Heart transplantation among patients was performed mainly due to cardiomyopathy (77.8%). Eighteen patients survived and were discharged 18 (72%). Four patients were treated with cardiopulmonary resuscitation before ECMO, and three patients died in the hospital. No differences existed among the surviving and death group donors (N-terminal pro b-type natriuretic peptide（NT-proBNP）, creatine kinase-muscle/brain（CK-MB）, warm ischemia time of donated heart, cold ischemia time of donated heart, total ischemia time of donated heart, and donator type). Univariate analysis showed that body mass index(BMI), length of stay in intensive care unit(ICU), and cardiopulmonary resuscitation are relevant prognosis factors in applying ECMO for patients with heart transplantation. Multi-factor logistic regression results show that cardiopulmonary resuscitation before ECMO (OR: 49.45, 95% CI[1.37, 1781.6]; P=0.033) is an independent risk factor influencing prognosis. Conclusion ECMO is an important life support method for patients with heart transplantation before and after the operation. Patients with obesity, poor preoperative cardiac function, and considerable red blood cell transfusions during surgery may influence the prognosis of patients. Extracardiac compression before ECMO of patients is an independent risk factor for their prognosis.
TCT-818 Clinical Outcomes of Awake Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation
