ECMO as a bridge to heart transplantation

Heart Transplantation remains the gold standard for treatment of end-stage heart failure refractory to medical management. Extracorporeal life support (ECLS) is an effective, emergent therapy for patient who are suffering from end-stage heart failure refractory to medical management in the setting of the nationwide shortage in donor organs. The use of ECLS has increased over time in United States as well as the evidence that this modality can be employed as a bridge to decision, bridge to recovery, bridge to durable left ventricular assist device and orthotopic heart transplantation in a select group of patients [1, 2]. In this chapter we will further explore ECLS, specifically veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO) as a bridge to orthotopic heart transplantation. We will discuss patient selection, timing of support, management and outcomes.