Bedside Rehabilitation with Peripheral Cannulation in ECMO as a Bridge to Heart Transplantation: A Preliminary Single-Center Experience
Presented During: Welcome Reception and Poster Competition | Sponsored by: TransMedics
Chonnam National University Hospital and Medical School
Gwangju, KY
South Korea - Contact Me
A. Education
1. 1992.03-1998.02: Bachelor (Chonnam National University, Medical School, Republic of Korea)
2. 1999.03-2001.02: Master (Chonnam National University, Medical School, Republic of Korea)
3. 2001.03- 2011.08: PhD (Chonnam National University, Medical School, Republic of Korea)
B. Position
Cardiothoracic Surgeon and Professor
Department of Thoracic and Cardiovascular Surgery
Chonnam National University Hospital and Medical School
Gwangju, Republic of Korea
Friday, September 20, 2024: 5:00 PM - 6:30 PM
Omni King Edward Hotel
Description
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.
Authors
Inseok Jeong (1)
Institutions
(1) Chonnam National University Hospital and Medical School, Gwangju, OH
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.
Authors
Inseok Jeong (1)
Institutions
(1) Chonnam National University Hospital and Medical School, Gwangju, OH