Bedside Rehabilitation with Peripheral Cannulation in ECMO as a Bridge to Heart Transplantation: A Preliminary Single-Center Experience

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Abstract Submission 

Inseok Jeong (1)

(1) Chonnam National University Hospital and Medical School, Gwangju, OH

Inseok Jeong    -  Contact Me
Chonnam National University Hospital and Medical School

Inseok Jeong    -  Contact Me
Chonnam National University Hospital and Medical School

Objective:
Despite the increasing use of Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to heart transplantation, patient outcomes remain suboptimal. Waiting for transplantation in a state of peripheral cannulation is controversial, particularly due to the high risk of complications arising from immobilization.

Methods:
We retrospectively reviewed patients who received VA-ECMO as a bridge to heart transplantation at regional hub hospital between January 2018 and December 2023.

Results:
Of the 33 heart transplant recipients, 25 were bridged with ECMO. The median age of these patients was 61 years (range 31-74 years). The median duration from ECMO initiation to transplantation was 22 days (9-36 days). Sixteen patients (64%) survived and were discharged, with a median waiting time of 18 days. Fourteen were on peripheral cannulation. All surviving patients proceeded with transplantation in a non-intubated and awakening state. A median time to stand-up alone is 14 days (3-64 days).

Conclusions:
Most patients underwent transplantation in a non-intubated, awake state, with early mobilization contributing to positive outcomes. Despite the risks of immobilization, this approach led to a majority of patients being successfully transplanted and discharged. Further research is needed to confirm these preliminary findings.

Heart Transplant