Table 5.
Reasons for textbook outcome (TO) failure stratified by planned use of venoarterial extracorporeal membrane oxygenation (VA ECMO) support.
| Reasons for TO failure | Planned Off-pump N = 169 |
Planned VA ECMO N = 68 |
Total N = 237 |
|---|---|---|---|
| Intraoperative complication | 6 (3.6%) | 3 (4.4%) | 9 (3.8%) |
| Reintervention within 30 days | 32 (18.9%) | 22 (32.4%) | 54 (22.8%) |
| Surgical | 27 (16.0%) | 20 (29.4%) | 47 (19.8%) |
| Re-exploration for bleedinga | 17 (63.0%) | 15 (75.0%) | 32 (68.1%) |
| Re-exploration for infectiona | 2 (7.4%) | 1 (5.0%) | 3 (6.4%) |
| Pleural effusion evacuationa | 4 (14.8%) | 2 (10.0%) | 6 (12.8%) |
| Othera | 4 (14.8%) | 2 (10.0%) | 6 (12.8%) |
| Bronchoscopic | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
| Radiologic | 6 (3.6%) | 4 (5.9%) | 10 (4.2%) |
| Intensive care unit readmission within 30 days | 29 (17.2%) | 13 (19.1%) | 42 (17.7%) |
| Hospital readmission within 30 days | 50 (29.6%) | 13 (19.1%) | 63 (26.6%) |
| Post-transplant length of stay >30 days | 56 (33.1%) | 30 (44.1%) | 86 (36.3%) |
| Mortality within 90 days | 2 (1.2%) | 4 (5.9%) | 6 (2.5%) |
| Acute rejection within 30 days | 19 (11.2%) | 1 (1.5%) | 20 (8.4%) |
| Grade 3 primary graft dysfunction at 48 or 72 hours | 28 (16.6%) | 8 (11.8%) | 36 (15.2%) |
| ECMO within 72 hours post-transplant | 21 (12.4%) | 14 (20.6%) | 35 (14.8%) |
| Timing of post-transplant ECMO initiation b | |||
| Cannulated in the operating room prior to transfer to the intensive care unit | 20 (95.2%) | 14 (100%) | 34 (97.1%) |
| Postoperative day 1 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
| Postoperative day 2 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
| Postoperative day 3 | 1 (4.8%) | 0 (0.0%) | 1 (2.9%) |
| Post-transplant ECMO mode | |||
| None | 146 (86.4%) | 54 (79.4%) | 200 (84.4%) |
| VA | 2 (1.2%) | 0 (0.0%) | 2 (0.8%) |
| VV | 21 (12.4%) | 14 (20.6%) | 35 (14.8%) |
| Renal replacement therapy during the index hospitalization | 16 (9.5%) | 6 (8.8%) | 22 (9.3%) |
| Tracheostomy within 7 days | 27 (16.0%) | 9 (13.2%) | 36 (15.2%) |
| Reintubation during the index hospitalization | 38 (22.5%) | 14 (20.6%) | 52 (21.9%) |
| Extubation >48 hours post-transplant | 104 (61.5%) | 27 (39.7%) | 131 (55.3%) |
ECMO, extracorporeal membrane oxygenation. TO, textbook outcome. VA, venoarterial. VV, venovenous.
a
Among patients who underwent surgical reintervention within 30 days.
b
Among patients who required ECMO within 72 hours post-transplant.