Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Peripheral Vascular Disease, Cardiovascular System & Cardiology, extracorporeal life support, liver transplantation, cardiac arrest, resuscitation, venovenous bypass, veno-arterial ECMO, EXTRACORPOREAL MEMBRANE-OXYGENATION, ADULTS, POSTREPERFUSION, MANAGEMENT, Cardiopulmonary Resuscitation, Extracorporeal Membrane Oxygenation, Heart Arrest, Humans, Liver Transplantation, 1S70220N|1S70222N#54752299, 1102 Cardiorespiratory Medicine and Haematology, 3201 Cardiovascular medicine and haematology

Abstract:

INTRODUCTION: Intraoperative cardiac arrest (ICA) is a feared complication during liver transplantation (LTx), typically occurring during reperfusion. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used for post-reperfusion cardiac arrest. CASE REPORT: We present a case of successful resuscitation after hyperkalemic ICA during the pre-anhepatic phase of a second liver transplantation by converting veno-venous bypass (VVB) to VA-ECMO. DISCUSSION: While this technique has been recommended for ICA during reperfusion, it has never been reported during the pre-anhepatic phase. VA-ECMO can be a lifesaving extension to cardiopulmonary resuscitation for ICA during LTx with beneficial neurological outcome by providing perfusion while the cause of ICA is reversed. CONCLUSION: Conversion of VVB to VA-ECMO should be considered in all patients who suffer from ICA during LTx with use of VVB. With VVB installed, conversion to VA-ECMO is fast and effective. If VVB is not used, early VA-ECMO should be considered for ICA.