Successful use of extracorporeal membrane oxygenation (ECMO) during BMT for SCID.
An 8-month-old girl with SCID presented with severe bronchiolitis. She received an HLA-identical sibling BMT without conditioning or GVHD prophylaxis. She deteriorated despite mechanical ventilation but had normal cardiac, hepatic and renal function. ECMO was instituted on day +3 and subsequent improvement was seen concurrently with emergence of CD4+ cells on day +11. She was taken off ECMO on day +18 and suffered a left-sided stroke evidenced by a dense left hemiplegia. She was extubated on day +25 and weaned from supplemental oxygen on day +36 and at day +100 has recovered strength in her extremities. This is the first successful use of ECMO as a bridge to engraftment in a BMT patient.
Leahey
A M
AM
Department of Pediatrics, The Children's Hospital of Philadelphia and the University of Pennsylvania, 19104, USA.
Bunin
N J
NJ
Schears
G J
GJ
Smith
C A
CA
Flake
A W
AW
Sullivan
K E
KE
D016026:Bone Marrow Transplantation; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016511:Severe Combined Immunodeficiency / Q000628:therapy*