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Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation.
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Published: 2014-10-21

The Effect of the Sequential Therapy in End-Stage Heart Failure (ESHF) - from ECMO, Through the Use of Implantable Pump for a Pneumatic Heart assist System, Religa Heart EXT, as a Bridge for Orthotopic Heart Transplant (OHT). Case Study

Grzegorz Religa, Małgorzata Jasińska, Łukasz Czyżewski, Krzysztof Torba, Jacek Różański

(Department of Cardiac Surgery and Transplantation, Institute of Cardiology, Warsaw, Poland)

Ann Transplant 2014; 19:537-540

DOI: 10.12659/AOT.891266

Background: Modern Polish medicine offers patients various treatments for end-stage treatment-resistant heart failure.
Methods applied at the right time before the occurrence of irreversible changes in organs give a chance for survival and prolong life.
Case Report: Here, we report on the safety and efficacy of the sequential use of the above treatments in a 58-year old patient with heart failure in dilatative cardiomyopathy (DCM). A 7-day mechanical blood circulatory support and extracorporeal membrane oxygenation of blood (ECMO), followed by a 13-day implantation of a left ventricular assist device, Religa Heart EXT, was used as a bridge to a successful orthotopic heart transplant (OHT). On Day 40 after OHT, the patient was discharged home with stable function of the circulatory system.
We describe our experiences with the qualification, preparation, and procedure of sequential ECMO, Religa Heart EXT, and OHT.
Conclusions: Application of short-term ECMO as a bridge-to-bridge helped save the patient from severe cardiogenic shock caused by increased left ventricular afterload. The experimental implantation of an innovative Religa Heart EXT prosthesis was a safe and efficacious bridge to transplantation.
Too short time of Religa Heart EXT implantation in the discussed patient prevented the possibility to evaluate the occurrence of thromboembolic complications and infections compared to the documented complications of POLVAD implanted until now.
OHT is a safe and efficacious method of treatment of patients previously supported by ECMO and Religa Heart EXT.

Keywords: Extracorporeal Membrane Oxygenation, Heart Failure, Heart Transplantation, Heart-Assist Devices

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