• Sandrine Jean, Christophe Chardot, Mehdi Oualha, Carmen Capito, Olivier Bustarret, Philippe Pouard, Sylvain Renolleau, Florence Lacaille, and Laurent Dupic.
• Pediatric Intensive Care Unit, Hôpital Armand-Trousseau, Paris, France.
• Artif Organs. 2017 Sep 1; 41 (9): 862-865.

AbstractThe risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life-saving. Four children with either acute pulmonary (three) or cardiac (one) failure after LT, and the criteria that decided the use of ECMO (level of ventilation and results, dosage of inotropic drugs, cardiac ultrasound, blood lactate) were retrospectively reported. These patients, 1-11 years old, were treated with either veno-arterial (three) or veno-venous (one) ECMO. Two experienced a full recovery, with 3 and 6 years of follow-up. Two died of systemic inflammatory response syndrome (SIRS) due to ECMO, and relapse of heart failure due to the underlying disease. Although our patients' survival was only 50%, we showed that ECMO can be useful in children after LT. It should be considered before the development of irreversible multiorgan failure.© 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

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