Extracorporeal life support as a bridge to heart transplantation: importance of organ failure in recipient selection.
We investigated the utility of comprehensive scoring systems for organ failure compared with the duration of extracorporeal life support (ECLS) in predicting survival after heart transplantation. From November 2004 to August 2013, 25 adult patients ultimately underwent heart transplantation while on ECLS. We did not include patients who were younger than 18 years old or patients with extracorporeal ventricular assist devices. Seven patients (28%) died within 1 year after transplantation. The areas under the curve (receiver operating characteristics (ROC), optimal cut-off value) of the sequential organ-failure assessment and the model for end-stage liver disease score modified by the United Network for Organ Sharing scores were 0.794 (13) and 0.825 (24), respectively. In multivariate analysis, the model for end-stage liver disease score modified by the United Network for Organ Sharing score was independently prognostic regardless of the duration of ECLS and sequential organ-failure assessment score.
From the *Department of Thoracic and Cardiovascular Surgery, and †Department of Internal Medicine, Division of Cardiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yang Hyun
YH
Cho
Ji-Hyuk
JH
Yang
Kiick
K
Sung
Dong Seop
DS
Jeong
Pyo Won
PW
Park
Wook Sung
WS
Kim
Young Tak
YT
Lee
Eun-Seok
ES
Jeon
D000293:Adolescent; D000328:Adult; D000368:Aged; D058625:End Stage Liver Disease / Q000150:complications; D005112:Extracorporeal Circulation; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000601:surgery; D016027:Heart Transplantation / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D018579:Patient Selection; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000150:complications / Q000601:surgery*; D055815:Young Adult