Case Report: Successful Use of Extracorporeal Therapies After ECMO Resuscitation in a Pediatric Kidney Transplant Recipient

Frontiers in Pediatrics

article

Andrey Rybalko¹  Anna Pytal¹  Mikhail Kaabak²  Nadejda Rappoport²  Anuar Bidzhiev¹  Vasilii Lastovka¹ 

[1] Intensive Care Unit, National Medical Research Center for Children's Health;Organ Transplantation Department, National Medical Research Center for Children's Health

关键词: kidney transplantation;    cardiac arrest;    ECMO;    immunosuppression;    plasma exchange;    CytoSorb;    lipopolysaccharide adsorption;   

DOI  :  10.3389/fped.2020.593123

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The combination of extracorporeal membrane oxygenation (ECMO) and extracorporeal blood purification in children is rarely used due to small total blood volumes, risks of hemodynamic instability and a negative association between volume of blood transfusion and patient outcome. To our knowledge, this is the first description of a multimodal extracorporeal detoxication in the setting of ECMO in a post-kidney-transplant child on immunosuppression. We describe a case of a 30-months old child, who was extracorporeally resuscitated after cardiac arrest during kidney transplantation surgery and additionally treated with a number of extracorporeal blood purification methods (plasma exchange, CytoSorb, and lipopolysaccharide adsorption) in the setting of immunosuppression therapy. This case report shows the successful use of multimodal extracorporeal therapies for a good patient outcome. The lack of response to CytoSorb therapy might suggest an occult infection and not necessarily failure of treatment.

【 授权许可】

CC BY