https://scholars.lib.ntu.edu.tw/handle/123456789/560321
標題: | Extracorporeal rescue for early and late graft failure after cardiac transplantation: Short result and long-term followup | 作者: | NAI-KUAN CHOU NAI-HSIN CHI HSI-YU YU JOU-WEI LIN CHIH-HSIEN WANG SHOEI-SHEN WANG YIH-SHARNG CHEN |
公開日期: | 2013 | 卷: | 2013 | 來源出版物: | The Scientific World Journal | 摘要: | Objectives. Graft failure after heart transplantation led to poor outcomes. We tried to analyze the outcomes of extracorporeal membrane oxygenation (ECMO) rescue in graft survival after transplantation. Methods. A retrospective review of 385 consecutive heart transplants revealed 46 patients of graft failure requiring ECMO rescue (48 episodes). The pretransplant and ECMO-related variables were evaluated. Results. The median age was 37.7 ± 18.8 years, and the median support time was 155 ± 145 hours. Success rate was 47.9% (23/48). Pretransplant ECMO use was 25% (12/48) and they had 58.3% mortality. The success rate in "early" graft failures was 51.4% (18/35) and 50% for "late" graft failure. The ischemic time with graft failure (178 ± 70 min) was significantly longer than that without graft failure. Preoperative status and the longer ischemic time may be the major factors for failure. Long-term 5-year survival demonstrated significant survival difference between graft failure and nongraft failure. No survival difference was shown between "early" and "late" graft failure. Conclusions. Graft failure still carried high mortality if advanced circulatory support was required. Early graft failure and late graft failure had similar outcomes. Further investigation of the risk factors shows that ECMO does play a role of rescue in catastrophic conditions. ? 2013 Nai-Kuan Chou et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84886663933&doi=10.1155%2f2013%2f364236&partnerID=40&md5=57736c6de7b70b05935cf6e8b64c609b https://scholars.lib.ntu.edu.tw/handle/123456789/560321 |
ISSN: | 1537-744X | DOI: | 10.1155/2013/364236 | SDG/關鍵字: | azathioprine; cyclosporin A; methylprednisolone; mycophenolic acid 2 morpholinoethyl ester; tacrolimus; adult; article; cardiac graft rejection; central venous catheter; centrifugal pump; clinical article; congestive heart failure; controlled study; extracorporeal oxygenation; female; graft failure; graft survival; heart muscle ischemia; heart transplantation; human; immunosuppressive treatment; medical record review; membrane oxygenator; outcome assessment; resuscitation; retrospective study; sudden cardiac death; follow up; graft rejection; heart failure; male; mortality; postoperative complication; prevalence; risk factor; survival rate; treatment outcome; Adult; Extracorporeal Membrane Oxygenation; Female; Follow-Up Studies; Graft Rejection; Heart Failure; Heart Transplantation; Humans; Male; Postoperative Complications; Prevalence; Risk Factors; Survival Rate; Treatment Outcome |
顯示於: | 醫學系 |
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