Successful resuscitation after hyperkalemic cardiac arrest during liver transplantation by converting veno-venous bypass to veno-arterial ECMO. (October 2021)

• Record Type: Journal Article
• Authors: Van Hoof, Lucas; Rega, Filip; Devroe, Sarah; Degezelle, Karlien; Pirenne, Jacques; Neyrinck, Arne
• Is Part Of: Perfusion. Volume 36:Number 7(2021)
• Page Start: 766
• Page End: 768
• Publication Date: 2021-10
• Subjects: extracorporeal life support -- liver transplantation -- cardiac arrest -- resuscitation -- venovenous bypass -- veno-arterial ECMO; Perfusion (Physiology) -- Periodicals; Blood -- Circulation, Artificial -- Periodicals; Heart -- Surgery -- Periodicals; Extracorporeal Circulation -- Periodicals; Perfusion -- Periodicals; Circulation extracorporelle -- Périodiques; Perfusion -- Périodiques; 617.41
• DOI: 10.1177/0267659120963898
• Languages: English
• ISSNs: 0267-6591

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.