Utilization of Veno-Arterial Extracorporeal Life Support for Acute Respiratory Distress Syndrome After Liver Transplant

Marwan Sheckley, Esteban Calderon, Bhavesh M. Patel, Ayan Sen, Emmanouil Giorgakis, Winston R. Hewitt, Andrew L. Singer, Kunam S. Reddy, Adyr A. Moss, Amit K. Mathur

Research output: Contribution to journalArticlepeer-review


In this report, we present a case of successful long-term salvage of a patient with transfusion-related acute lung injury associated with acute respiratory distress syndrome immediately after a liver transplant. The patient was a 29-year-old man with end-stage liver disease due to sclerosing cholangitis who underwent liver transplant. After organ reperfusion, there was evidence of liver congestion, acidosis, coagulopathy, and acute kidney injury. He received 61 units of blood products. Continuous renal replacement therapy was initiated intraoperatively. On arrival to the intensive care unit, the patient was on high-dose pressors, and the patient developed respiratory failure and was immediately placed on veno-arterial extracorporeal membrane oxygenation via open femoral exposure. The patient presented with severe coagulopathy and early allograft dysfunction; therefore, no systemic heparin was administered and no thrombotic events occurred. He required extracorporeal membrane oxygenation support until posttransplant day 4, when resolution of the respiratory and cardiac dysfunction was noted. At 2 years after liver transplant, the patient has normal liver function, normal cognitive function, and stage V chronic kidney disease. We conclude that extracorporeal membrane oxygenation is a valuable therapeutic approach in patients with cardiorespiratory failure after liver transplant.

Original languageEnglish (US)
Pages (from-to)616-620
Number of pages5
JournalExperimental and Clinical Transplantation
Issue number6
StatePublished - Jun 2022


  • Acute kidney injury
  • Acute lung injury
  • End-stage liver disease

ASJC Scopus subject areas

  • Transplantation


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