Role of ECMO for Organ donation
Vol 5 | Issue 2 | May-Aug 2019 | page: 1-3 | Jumana Yusuf Haji
Authors: Jumana Yusuf Haji[1]
[1] Department of Anesthesia, Aster CMI Hospital, Bengaluru, Karnataka 560092, India
Address of Correspondence
Dr Jumana Yusuf Haji
ECMO Program Director
Consultant Anaesthesia And Critical Care
Aster CMI Hospital
43/2, New Airport Road, NH.7, Sahakara Nagar, Bengaluru, Karnataka 560092, India
E-mail: drjumana.yusuf@asterhospital.com
Abstract
EC M O (e x t r a c o r p o r e a l m e m b r a n e o x y g e n a t i o n ) , a l s o c a l l e d E C L S (extracorporeal life support), in its actual application is an evolution of the heart-lung machines used in cardiac surgery. Depending on its configuration – venovenous or venoarterial – it is used to support either respiratory function, circulation, or both. Being a bridge therapy, it facilitates the healing of the natural organs or limits further damage to other vital organs such as kidney, liver, brain etc., due to hypoxia and low cardiac output state. ECMO has now become an extension of critical care armamentarium and also the spectrum of indications are widening, becoming more dependant on the clinical picture of the patient at presentation. With improved technology, the contraindications to ECMO are decreasing. As it is only a bridge to recovery, mortality rate may still be significant if the diseased organ does not heal. The therapy requires cannulation of major blood vessels and anticoagulation to prevent coagulation and support circulation through an external circuit and oxygenator. India as a country is experiencing an explosion in the use of ECMO and developing ECMO programs. As the infrastructure required to support an ECMO program is the same as that for a transplant program more and more transplant centers will also develop into ECMO centers. Hence it is inevitable that the applications of ECMO will extend to organ donation and use in posttransplant patients.
References
1. Bronchard, Régis, et al. “Brain-Dead Donors on Extracorporeal Membrane Oxygenation*.” Critical Care Medicine , vol. 45, no. 10, 2017, pp. 1734–1741., doi:10.1097/ccm.0000000000002564.
2. Kreitler, Kristin J., et al. “Declaring Brain Death on ECMO.” Jefferson Digital Commons , 2 May 2015, jdc.jefferson.edu/jhnj/vol12/iss1/7.
3. Dalle Ave, Anne L, et al. “The Ethics of Extracorporeal Membrane Oxygenation in Brain-Dead Potential Organ Donors.” Transplant International Official Journal of the European Society for Organ Transplantation , U.S. National Library of Medicine, May 2016, www.ncbi.nlm.nih.gov/pubmed/26987689.
4. Hsieh, C.-E., et al. “Extracorporeal Membrane Oxygenation Support in Potential Organ Donors for Brain Death Determination.” Transplantation P r o c e e d i n g s , v o l . 4 3 , n o . 7 , 2 0 11 , p p . 2 4 9 5 – 2 4 9 8 . , doi:10.1016/j.transproceed.2011.06.027.
5. Dalle Ave AL. “Ethical Issues in the Use of Extracorporeal Membrane Oxygenation in Controlled Donation After Circulatory Determination of D e a t h . ” R e a d b y Q x M D I c o n , 2 0 1 6 ,
read.qxmd.com/read/26999771/ethical-issues-in-the-use-ofextracorporeal-membrane-oxygenation-in-controlled-donationaftercirculatory- determination-of-death.
How to Cite this Article: Haji J Y. Role of ECMO for Organ donation Journal of Anaesthesia and Critical Care Case Reports May-Aug 2019; 5(2):1-3. |
(Abstract) (Full Text HTML) (Download PDF)
.
Tags: ECMO, Editorial