Should VV ECMO be considered as treatment option in COVID-19 infection after kidney transplant? A word of caution.

Autor: Breda JR; Division of Thoracic Transplantation and Mechanical Support, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Parker BM; Division of Trauma and Surgical Critical Care, University of Miami Miller School of Medicine, Miami, Florida, USA., Guerra G; Division of Kidney Transplant, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Dawson A; Medical Student, Ross University School of Medicine, Miramar, Florida, USA., Loebe M; Division of Thoracic Transplantation and Mechanical Support, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2023 Aug; Vol. 37 (8), pp. e15020. Date of Electronic Publication: 2023 May 17.
DOI: 10.1111/ctr.15020
Abstrakt: Several reports have shown that hospitalized kidney transplant recipients (KTR) had high mortality rates when infected with COVID-19. Extracorporeal Membrane Oxygenation (ECMO) has been shown to be an option for refractory respiratory failure in COVID-19 patients with variable rates of recovery. The outcome of ECMO in respiratory failure is highly related to cohort investigated and patient selection. Over a 10-month period in the height of COVID-19 pandemic 5 KTR patients were placed on ECMO with none of the patients surviving to discharge. All patients experienced multisystem organ failure (MSOF) and hematologic pathology while on ECMO. We concluded that COVID-19 in KTR patients presents with a refractory MSOF that is not well supported with ECMO in a traditional approach. Future work is needed to determine how to best support refractory respiratory failure in KTR patients with COVID-19.
(© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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