Preoperative ECMO Bridging in Pediatric Heart Transplantation:A Cohort Study on Graft Remodeling,Inflammatory Biomarkers and SurvivalOA
Background:To investigate the impact of preoperative extracorporeal membrane oxygenation(ECMO)on clinical outcomes in pediatric heart transplantation(PHT).Methods:This retrospective cohort analysis was conducted on 19 pediatric heart transplant recipients,divided into two groups:ECMO and non-ECMO,based on whether preoperative ECMO was utilized.We evaluated the patients''surgical conditions,postoperative complications,and survival rates.Additionally,the analysis focused on the differences and correlations in clinical characteristics,inflammatory markers,and long-term survival outcomes.Results:There was no statistically significant difference in perioperative survival rates between the ECMO group(85.7%)and the non-ECMO group(83.3%).However,the ECMO group exhibited significantly higher levels of inflammatory markers,including Interleukin-6(IL-6),Interleukin-8(IL-8),Interleukin-6(IL-10),Tumor Necrosis Factor-a(TNF-α),and C-reactive protein(CRP),compared to the non-ECMO group(p<0.05).Notably,IL-6,IL-8,and CRP levels in the ECMO group were found to normalize to the levels of the non-ECMO group 24 h after the operation.The cohort demonstrated a mean donor-recipient weight ratio of 1.38±0.39,with successful cardiac remodeling observed in recipients of oversized grafts,with the highest Donor-RecipientWeight Ratio(DRWR)reaching 3.0.Conclusions:The donor-recipient size mismatch plays a significant role in influencing the success rate of PHT.Despite the inflammatory response and perioperative complications,ECMO proves to be an effective bridging strategy,ultimately enhancing overall outcomes in PHT.
Hui Yi;Hongjian Shi;Fuquan Kan;Fan Han;LeiWan;Xiaoyang Hong;Zhe Zhao;Junjie Shao;Gang Wang;HuiWang;Hua Yan;Xiujuan Shi;Ran Zhang;Gengxu Zhou
Division of Pediatric Cardiology,Department of Pediatric Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,China Chinese PLA Medical School,Beijing,100853,ChinaChinese PLA Medical School,Beijing,100853,China Department of Radiology,Hospital of Jiangxi Provincial Corps,Chinese People''s Armed Police Force,Nanchang,330030,ChinaChinese PLA Medical School,Beijing,100853,China Department of Health,Beijing Garrison Security Bureau of the Chinese PLA,Beijing,100009,ChinaChinese PLA Medical School,Beijing,100853,ChinaDepartment of Health Service,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,ChinaDivision of Pediatric Cardiology,Department of Pediatric Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,ChinaDivision of Pediatric Cardiology,Department of Pediatric Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,ChinaChinese PLA Medical School,Beijing,100853,ChinaDivision of Pediatric Cardiology,Department of Pediatric Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,ChinaDivision of Pediatric Cardiology,Department of Pediatric Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,ChinaDepartment of Health Service,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,ChinaDivision of Pediatric Cardiology,Department of Pediatric Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,ChinaChinese PLA Medical School,Beijing,100853,China Department of Cardiovascular Medicine,The First Medical Center of Chinese PLA General Hospital,Beijing,100853,ChinaDivision of Pediatric Cardiology,Department of Pediatric Medicine,The Seventh Medical Center of Chinese PLA General Hospital,Beijing,100700,China
医药卫生
Pediatric heart transplantationdonor-recipient weight ratioextracorporeal membrane oxygenationcytokine
《Congenital Heart Disease》 2025 (4)
P.519-530,12
supported by National Key Research and Development Program of China(Grant Nos.2021YFC2701700&2021YFC2701703)Special Research Project on Family Planning of the Logistics Support Department of the Military Commission(20JSZ15).
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