Extracorporeal membrane oxygenation support for refractory septic shock in liver transplantation recipients.
10.4174/astr.2017.93.3.152
- Author:
Kyo Won LEE
1
;
Chan Woo CHO
;
Nuri LEE
;
Gyu Seong CHOI
;
Yang Hyun CHO
;
Jong Man KIM
;
Choon Hyuck David KWON
;
Jae Won JOH
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. chdkwon@gmail.com
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Septic shock;
Extracorporeal membrane oxygenation
- MeSH:
APACHE;
Bilirubin;
Extracorporeal Membrane Oxygenation*;
Humans;
Lactic Acid;
Liver Transplantation*;
Liver*;
Physiology;
Prognosis;
Shock, Septic*;
Survivors
- From:Annals of Surgical Treatment and Research
2017;93(3):152-158
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study was designed to assess the outcome of the extracorporeal membrane oxygenation (ECMO) in liver transplantation (LT) recipients with refractory septic shock and predict the prognosis of those cases. METHODS: From February 2005 to October 2012, ECMO was used in 8 cases of refractory septic shock. Laboratory values including lactate and total bilirubin level just before starting ECMO were obtained and sepsis-related organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACH) II score and simplified acute physiology score (SAPS) 3 were calculated. Subsequent peak serum lactate and total bilirubin level, and SOFA score after 24 hours of starting ECMO were measured. RESULTS: Comparisons were made between survivors and nonsurvivors. ECMO was weaned off successfully in 3 patients (37.5%) and 2 patients (25%) survived to hospital discharge. Clinical scores including SOFA, APACH II, and SAPS3 and laboratory results including lactate, total bilirubin and CRP were not significantly different between survivor and nonsurvivor groups. Lactate level and SOFA score tended to decrease after ECMO support in survivor group and total bilirubin and CRP level tended to increase in nonsurvivor group. CONCLUSION: Our findings suggest that the implantation of ECMO might be considered in highly selected LT recipients with refractory septic shock.
