Use of extracorporeal life support as a bridge to pediatric cardiac transplantation. |
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| Authors: | Robert J Gajarski Ralph S Mosca Richard G Ohye Edward L Bove Dennis C Crowley Joseph R Custer Frank W Moler Alicia Valentini Thomas J Kulik |
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| Affiliation: | Division of Pediatric Cardiology, Department of Pediatrics, University of Michigan, C. S. Mott Children's Hospital, Ann Arbor, Michigan, USA. rjgaj@umich.edu |
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| Abstract: | BACKGROUND: Extracorporeal life support (ECLS) has been used for post-cardiotomy rescue, but its use as a bridge to heart transplantation (OHT) in patients with post-surgical or end-stage ventricular failure remains controversial. METHODS: Records were reviewed for patients receiving ECLS for ventricular failure from January 1991 to August 2001. Patients listed for OHT were analyzed separately. Listing for OHT requirements were improbable myocardial recovery, absence of contraindications (central nervous system damage, high pulmonary resistance, ongoing infection, etc.), and parental consent. Outcome variables included patient demographics, diagnosis, days from ECLS initiation to United Network for Organ Sharing (UNOS) listing (latency), list time, renal function, and survival to discharge. RESULTS: Of 145 patients with ventricular failure who received ECLS, 21 pediatric patients were UNOS listed. Of 124 non-listed patients, 57 (46%) survived to discharge. All but 3 survivors were separated from ECLS in
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