ArticleJournal of cardiothoracic surgery2026
Veno-arterial extracorporeal membrane oxygenation as a bridge to heart transplantation for end-stage heart failure: a single-centre retrospective analysis.
Article in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesHeart transplantation is a key treatment for end-stage heart failure. However, few donors and long waits for transplant availability mean that patients may not receive the procedure in time. This study analysed the suitability of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation.
designThis study was retrospective.
settingThis single-centre study took place in cardiac center of a tertiary hospital.
participantsThe participants comprised 15 patients with end-stage heart failure.
interventionsAll 15 participants underwent heart transplantation under VA-ECMO–assisted circulation; six participants received extracorporeal cardiopulmonary resuscitation (ECPR). MEASUREMENTS AND MAIN
resultsThe mean age was 41.80 ± 16.00 years, and the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 23.20 ± 5.80. The median preoperative ECMO support duration was 168.00 h (interquartile range [IQR], 132.00–216.00 h). All patients required preoperative mechanical ventilation. The mean surgical duration was 432.13 ± 65.43 min. Postoperative ECMO was maintained in seven cases, with a median duration of 72.00 h (IQR, 24.00–120.00 h). Three in-hospital deaths occurred, resulting in 12 successful discharges. The median postoperative intensive care unit stay was 11.00 d (IQR, 4.50–14.50 d), and the median postoperative hospital stay was 35.00 d (IQR, 20.50–55.50 d). The postoperative 30-day mortality rate was 20% (3/15). Patients who underwent ECPR had a higher 30-day mortality rate (33.3%, 2/6) than those who did not (11.1%, 1/9), though the difference was not statistically significant (P = 0.527). The cumulative 1-year survival rate for all 15 patients was 60%, while for the 12 discharged patients, it was 75%.
conclusionsVA-ECMO can effectively stabilize patients with end-stage heart failure, serving as a viable short-term bridge to heart transplantation for select individuals. Appropriate patient selection via risk factor stratification is necessary to improve short-term outcomes. Direct bridging to heart transplantation following ECPR is not an ideal therapeutic strategy and requires careful consideration of intermediate risk-mitigation steps.
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