Citations 2
Extracorporeal membrane oxygenation as a salvage therapy for patients with severe primary graft dysfunction after heart transplant
Jacob, Samuel , Lima, Brian , Gonzalez‐Stawinski, Gonzalo V. , Ahmed, Magdy M. El‐Sayed , Patel, Parag C. , Belli, Erol, Makey, Ian A. , Thomas, Mathew , Landolfo, Kevin , Landolfo, Carolyn, Leoni, Juan , Yip, Daniel , Thomas, Mathew , Belli, Erol V, Leoni Moreno, Juan Carlos, Yip, Daniel S, Pham, Si M. , Thomas, Mathew , Thomas, Mathew, Leoni, Juan Carlos
Clinical Transplantation | March 14, 2019 | Volume: 33 | Issue: 5 | Pages: No page available
AbstractBackgroundSevere primary graft dysfunction (PGD) is the leading cause of early death after heart transplant.AimTo examine the outcomes of heart transplant recipients who received venoarterial extracorporeal membrane oxygenation (VA‐ECMO) for severe PGD.MethodsWe reviewed electronic health records of adult patients who underwent heart transplant from November 2005 through June 2015. We defined severe PGD according to International Society for Heart and Lung Transplantation consensus statements.ResultsOf 1030 heart transplant patients, 31 (3%) had severe PGD and required VA‐ECMO. The mean (range) age was 59 (43‐69) years. Fifteen patients (48%) underwent prior sternotomy and 10 (32%) received a left ventricular assist device as a bridge to transplant. Severe PGD manifested as failure to wean from cardiopulmonary bypass in 20 patients (65%) and as severe hemodynamic instability in the immediate postoperative period in 10 (32%), including cardiac arrest in 3 (10%). Twenty‐five patients (81%) were successfully weaned from VA‐ECMO, and 19 (61%) were discharged; the other 12 (39%) died.ConclusionsAlthough VA‐ECMO is a common method for providing mechanical circulatory support to patients with PGD, multicenter studies are needed to assess factors associated with successful outcomes and improved survival of these patients.
Lung transplant patients with coronary artery disease rarely die of cardiac causes
Makey, Ian A. , Sui, Jin W., Huynh, Charles, Das, Nitin A. , Thomas, Mathew , Johnson, Scott, Thomas, Mathew , Thomas, Mathew , Huynh, Charles, Thomas, Mathew
Clinical Transplantation | July 19, 2018 | Volume: 32 | Issue: 9 | Pages: No page available
AbstractBackgroundA relative contraindication for lung transplant (LT) is coronary disease burden sufficient to cause risk of myocardial infarction after LT. We analyzed cause of death and outcomes of our LT patients with coronary artery disease (CAD).MethodsInpatient records from March 1, 2004, to January 31, 2015, were retrospectively examined and data of 306 LTs extracted. Twenty‐five patients without coronary angiography (CA) and 7 with redo LTs were excluded. The other 274 patients were divided into 2 groups: CAD (n = 116) and no CAD (n = 158). Patients with prior revascularization or coronary stenosis >10% were placed into the CAD group.ResultsThe CAD group was older and had more male patients, greater history of smoking and hypertension, and greater proportion of patients with interstitial lung disease than the no‐CAD group. CAD patients were more likely to receive a single‐lung transplant. Death of cardiac causes occurred for 2 patients (1.7%) in the CAD group and for 1 patient (0.6%) in the no‐CAD group (P = 0.39).ConclusionsThis analysis shows that compared with patients who have no CAD, patients with CAD have different demographic characteristics and receive more single‐lung transplants. Incidence of death of cardiac causes is rare.