Extracorporeal membrane oxygenation bridging heart transplantation in the treatment of two children with end-stage heart failure
10.3760/cma.j.issn.1673-4912.2023.08.005
- VernacularTitle:体外膜肺氧合桥接心脏移植救治心力衰竭终末期患儿两例
- Author:
Xiaohong WU
1
;
Yingyue LIU
;
Zhe WANG
;
Jing WANG
;
Zhe ZHAO
;
Xiaoyang HONG
;
Feng WANG
;
Jie WANG
;
Zhichun FENG
Author Information
1. 中国人民解放军总医院第七医学中心儿科医学部儿童重症医学科，北京 100700
- Keywords:
Extracorporeal membrane oxygenation;
Heart transplantation;
Bridge;
Children
- From:
Chinese Pediatric Emergency Medicine
2023;30(8):584-589
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application of extracorporeal membrane oxygenation(ECMO)bridging heart transplantation in critically ill children.Methods:The clinical data of two cases of critical infants with venous-arterial ECMO(VA-ECMO)bridging heart transplantation and literature review were retrospectively analyzed.Results:Two cases received orthotopic heart allograft with VA-ECMO support, and were discharged uneventfully without significant postoperative complications.On the 13th day of ECMO assistance, the first child was treated with orthotopic heart transplantation in a hospital qualified for heart transplantation, and the ECMO was evacuated during the operation.After 21 days of the heart transplantation, the patient was discharged from the hospital.The patient was followed up to be healthy after heart transplantation, and had the same development as children of the same age, and had been taking anti-rejection drugs for a long time.On the 10th day of VA-ECMO treatment, the second case received awake ECMO after cardiac function improved.On the 12th day of VA-ECMO treatment, the patient was successfully evacuated from VA-ECMO and waited for heart transplantation.Cardiac orthotopic transplantation was performed after the 17 days after VA-ECMO evacuation.The patient was transferred to the general ward after 6 days of hospitalization in the intensive care unit, and was discharged 23 days after transplantation with conventional anti-rejection therapy.Discharge follow-up in good health, normal school life.Conclusion:When VA-ECMO cannot be withdrawn from the heart of the critically ill children and the end-stage heart, VA-ECMO bridging heart transplantation should be selected at the right time for the children who meet the indications for heart transplantation to create survival opportunity for the previously hopeless children, save the life of the end-stage children, and improve the quality of life.
