Intensive pulmonary support using extracorporeal membrane oxygenation in adult patients undergoing liver transplantation.

• DOI: 10.5754/hge10125
• Publication Date: 2012-06-01
• Authors: Nam Kyu Choi; Shin Hwang; Kwan Woo Kim; Gil Chun Park; Young‐Dong Yu; Sung Ho Jung; Pyung Jae Park; Young Il Choi; Gi‐Won Song; Dong Hwan Jung; Suk‐Kyung Hong; Chul Soo Ahn; Ki Hun Kim; Deok Bog Moon; Tae Yong Ha; Sung‐Gyu Lee
• Keywords: Extracorporeal; Refractory (planetary science)

Adult liver transplantation (LT) recipients occasionally show serious acute cardiopulmonary dysfunction, requiring intensive care. We have assessed the feasibility of extracorporeal membrane oxygenation (ECMO) support in adult LT facing pulmonary failure and refractory to conventional mechanical ventilation concurrent nitric oxide gas inhalation.From January 2008 June 2009, 9 required ECMO due pneumonia (n=5) respiratory distress syndrome (n=4). Mean age was 52.6 ± 5.9 years mean model for end-stage disease score 29.0 7.5. Five patients underwent living-donor four deceased-donor LT.Veno-venous access mode used continuous veno-venous hemodiafiltration performed concurrently all patients. No procedure related complications occurred. Successful weaning achieved 4 (44.4%) at first attempt, after 12.0 6.8 days but other five died overwhelming infection prior weaning. Univariate analysis revealed no significant risk factors failing before start.ECMO as rescue therapy seems beneficial be considered a final therapeutic option with dysfunction who would otherwise die hypoxemia.