Elective extracorporeal membrane oxygenation bridge to recovery in otherwise 'unusable' donor hearts for children: Preliminary outcomes

摘要

The number of pediatric donor hearts offered for transplantation remains far lower than the number of potential recipients. Mechanical support has allowed transplant (Tx) numbers to be maintained but at the cost of long wait times and increased morbidity and mortality. Many donor organs are not accepted due to poor function, yet transient donor organ dysfunction is common after brainstem death and donors with poor function have been successfully utilized.Extracorporeal membrane oxygenation (ECMO) support has been utilized for unanticipated primary graft failure and in adults for prolonged ischemic times. Accepting donor hearts with known poor function and electively supporting them to recovery with ECMO is therefore a logical progression for patients in extremis.