A study on the application of predictive extracorporeal membrane oxygenation intraoperative support in high-risk liver transplant recipients
10.12464/j.issn.1674-7445.2026007
- VernacularTitle:预判性体外膜肺氧合术中支持在高危肝移植受者中的应用研究
- Author:
Zhiying LEI
1
;
Xuyong SUN
2
;
Yuanyuan MO
1
;
Jianhui DONG
1
;
Ning WEN
1
;
Rong PENG
1
;
Juhua ZENG
1
;
Silin LI
1
Author Information
1. Transplant Medicine Research Institute, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China.
2. Transplant Medicine Research Institute, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China;null;null.
- Publication Type:OriginalArticle
- Keywords:
Extracorporeal membrane oxygenation;
Liver transplantation;
High-risk patient;
Predictive support;
Model for end-stage liver disease;
Cardiac output;
Cardiac index;
Activated clotting time
- From:
Organ Transplantation
2026;17(4):618-624
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical safety and efficacy of predictive extracorporeal membrane oxygenation (ECMO) support during liver transplantation in high-risk recipients. Methods A single-center retrospective study was conducted. A total of 35 liver transplant recipients who underwent predictive ECMO assistance during surgery at the Second Affiliated Hospital of Guangxi Medical University from January 2021 to April 2025 were included. Baseline characteristics, ECMO application, ECMO operating parameters and hemodynamic conditions during ECMO operation were analyzed. The cumulative survival rate was calculated using the Kaplan-Meier method and survival curves were plotted. Results Veno-arterial ECMO in 35 recipients was established after induction of general anesthesia. The median ECMO operation time was 8.5 h, and the success rate of weaning from ECMO was 97%. The cardiac index (CI) during the non-liver period and the new liver period was higher than that before cannulation, and CI increased during the non-liver period and before weaning (all P<0.001). The mean invasive arterial pressure and central venous pressure remained stable. No ECMO-related complications occurred in the recipients. The average survival time was (25 ± 3) months. The main causes of death were severe pulmonary infection and multiple organ failure. Conclusions For liver transplant recipients with severe cardiopulmonary dysfunction, hemodynamic disorders, or multiple organ failure risk factors, implementing predictive ECMO support during liver transplantation through active risk prediction is a safe and effective circulatory guarantee strategy.
