Frontiers in transplantation · 2025
Application of venovenous extracorporeal membrane oxygenation combined with continuous renal replacement therapy in a high-risk liver transplant recipient: a case report.
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Yang Li Wen, Zhang Yunli, Lu Lijun, Xiong Bin
Аннотация
INTRODUCTION: This report describes the novel perioperative application of VV-ECMO combined with CRRT in a high-risk liver transplant recipient with irreversible hypoxemia and multi-organ dysfunction, expanding therapeutic options for traditionally contraindicated patients.
CASE PRESENTATION: A 27-year-old male with acute-on-chronic liver failure (chronic hepatitis B + alcoholic liver disease), hepatic encephalopathy, severe pulmonary infection, and coagulopathy developed life-threatening hypoxemia (PaO2 60 mmHg on FiO2 100%) during transplantation.
INTERVENTIONS: Emergency intraoperative VV-ECMO and postoperative CRRT were initiated.
OUTCOMES: ECMO was withdrawn on postoperative day 4, the ventilator on day 11, and the patient was discharged on day 61. Follow-up showed normal liver function.
CONCLUSION: Combined VV-ECMO/CRRT provides synergistic cardiopulmonary-renal support for high-risk liver transplants, creating a critical window for graft recovery. Multidisciplinary coordination is essential for success.
CASE PRESENTATION: A 27-year-old male with acute-on-chronic liver failure (chronic hepatitis B + alcoholic liver disease), hepatic encephalopathy, severe pulmonary infection, and coagulopathy developed life-threatening hypoxemia (PaO2 60 mmHg on FiO2 100%) during transplantation.
INTERVENTIONS: Emergency intraoperative VV-ECMO and postoperative CRRT were initiated.
OUTCOMES: ECMO was withdrawn on postoperative day 4, the ventilator on day 11, and the patient was discharged on day 61. Follow-up showed normal liver function.
CONCLUSION: Combined VV-ECMO/CRRT provides synergistic cardiopulmonary-renal support for high-risk liver transplants, creating a critical window for graft recovery. Multidisciplinary coordination is essential for success.