Intensive Care Medicine

, Volume 29, Issue 6, pp 985–988

Extracorporeal membrane oxygenation as a bridge to cardiac transplantation in a patient with cardiomyopathy and hemophilia A

  • Ravi R. Thiagarajan
  • Stephen J. Roth
  • Steven Margossian
  • Andrew S. Mackie
  • Ellis J. Neufeld
  • Peter C. Laussen
  • Joseph M. Forbess
  • Elizabeth D. Blume
Neonatal and Pediatric Intensive Care

DOI: 10.1007/s00134-003-1748-5

Cite this article as:
Thiagarajan, R.R., Roth, S.J., Margossian, S. et al. Intensive Care Med (2003) 29: 985. doi:10.1007/s00134-003-1748-5

Abstract

Objective

To report the use of extracorporeal membrane oxygenation (ECMO) as a bridge to cardiac transplantation in a patient with hemophilia A and dilated cardiomyopathy.

Design

Case report.

Interventions and results

During ECMO factor VIII concentrate was administered to maintain a factor VIII level close to 50% of normal control both to decrease the risk of bleeding and to allow standard anticoagulation with heparin. The patient developed an inhibitor to exogenous factor VIII during hospitalization, which was successfully managed with a high-dose continuous infusion of factor VIII during ECMO, the transplant operation, and the postoperative period.

Conclusions

We report the successful use of ECMO as a bridge to cardiac transplantation in a patient with hemophilia A and low-level factor VIII inhibitors.

Keywords

Dilated cardiomyopathyExtracorporeal membrane oxygenationHemophilia AFactor VIII inhibitorCardiac transplantation

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Ravi R. Thiagarajan
    • 1
    • 4
  • Stephen J. Roth
    • 1
    • 4
  • Steven Margossian
    • 2
    • 4
  • Andrew S. Mackie
    • 1
    • 4
  • Ellis J. Neufeld
    • 2
    • 4
  • Peter C. Laussen
    • 1
    • 4
  • Joseph M. Forbess
    • 3
    • 4
  • Elizabeth D. Blume
    • 1
    • 4
  1. 1.Department of CardiologyChildren's Hospital BostonBostonUSA
  2. 2.Division of HematologyChildren's Hospital BostonBostonUSA
  3. 3.Department of Cardiovascular SurgeryChildren's Hospital BostonBostonUSA
  4. 4.Departments of Pediatrics and Surgery, Dana Farber Cancer InstituteHarvard Medical SchoolBostonUSA