Case report: pediatric liver retransplantation on an extracorporeal membrane oxygenation-dependent child

Area of Science:

• Pediatric critical care medicine
• Organ transplantation
• Extracorporeal life support

Background:

• Liver retransplantation is a complex procedure, especially in pediatric patients.
• Extracorporeal membrane oxygenation (ECMO) provides vital life support for critically ill patients.
• Hepatic ischemia can necessitate emergent liver retransplantation.

Observation:

• A pediatric patient required liver retransplantation due to an ischemic liver graft.
• The patient was dependent on venovenous extracorporeal membrane oxygenation (ECMO) for respiratory support.
• Management included renal replacement therapy, inotropic support, and treatment for heparin-induced thrombocytopenia (HIT).

Findings:

• Successful perioperative management and liver retransplantation were achieved in an ECMO-dependent pediatric patient.
• This case represents the first reported instance of pediatric liver transplantation with concurrent ECMO support.
• Comprehensive management strategies were crucial for patient survival and graft success.

Implications:

• This case expands the understanding of managing critically ill pediatric patients undergoing complex organ transplantation.
• It demonstrates the feasibility and critical role of ECMO in supporting pediatric liver retransplantation.
• Highlights the importance of multidisciplinary care in managing ECMO-dependent patients with HIT undergoing major surgery.