Case report: pediatric liver retransplantation on an extracorporeal membrane oxygenation-dependent child.
We describe the perioperative management of a venovenous extracorporeal membrane oxygenator-dependent child requiring liver retransplantation after emergent hepatectomy because of an ischemic liver graft. This child required renal replacement and inotropic support as well as treatment for heparin-induced thrombocytopenia (HIT). We describe each step in this child's perioperative management leading to the successful liver retransplantation. This is the first description, to our knowledge, of a pediatric patient undergoing liver transplantation while supported by extracorporeal membrane oxygenation (ECMO).
Landsman
Ira S
IS
Department of Anesthesiology, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA. ira.landsman@vanderbilt.edu
Karsanac
Christopher J
CJ
D000925:Anticoagulants / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000139:chemically induced / Q000503:physiopathology / Q000601:surgery*; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D005260:Female; D006439:Hemodynamics; D006493:Heparin / Q000009:adverse effects*; D006498:Hepatectomy; D006801:Humans; D007511:Ischemia / Q000139:chemically induced / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D009102:Multiple Organ Failure / Q000209:etiology; D017582:Renal Replacement Therapy; D012086:Reoperation; D017131:Thrombectomy; D013921:Thrombocytopenia / Q000139:chemically induced / Q000503:physiopathology / Q000601:surgery*; D013927:Thrombosis / Q000139:chemically induced / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000139:chemically induced / Q000503:physiopathology / Q000601:surgery*
D000925:Anticoagulants; D006493:Heparin