Triple therapy temporary mechanical circulatory support as a bridge to triple-organ transplantation

Temporary mechanical circulatory support (MCS) systems are indicated to stabilize hemodynamically decompensating patients in cardiogenic shock refractory to medical management. These devices are currently used as short-term hemodynamic support to facilitate organ recovery or bridge to definitive therapy with durable MCS or heart transplantation. We present the sequential use of intra-aortic balloon pump, Impella 5.5®, and venoarterial extracorporeal membrane oxygenation as a bridge to heart-liver-kidney transplantation. The patient was supported for 78 days on Impella 5.5 and 95 days total temporary MCS. He had an uncomplicated postoperative course after triple-organ transplantation and was stable with no signs of rejection at 1-, 3-, 6-, and 12-month follow-up.