Day 1	ECMO-wean	Clinical course	Mortality
Patient 1	Patient undergoes orthotopic heart transplantation (OHTx). Surgery complicated by primary graft failure requiring peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO).	Day 10: Weaned off VA ECMO and decannulated. Developed right ventricular dysfunction over the next 12 h requiring temporary right ventricular assist device (RVAD).	Days 10–15: On temporary RVAD. Sedation weaned. Noted to have flaccid paralysis of lower limbs. Magnetic resonance imaging (MRI) was performed and confirms spinal cord infarction.	6 weeks later: Multiorgan failure. Treatment withdrawn.
Patient 2	Patient undergoes coronary artery bypass grafting + aortic valve replacement + maze procedure. Requires intra-aortic balloon pump (IABP) to be weaned off cardiopulmonary bypass. Develops low cardiac output over the next few hours requiring peripheral VA ECMO with removal of IABP.	Day 10: Weaned from peripheral VA ECMO and decannulated uneventfully. Noticed to have bilateral lower limb paralysis. MRI reveals spinal cord infarction.	—	Day 13: Biliary sepsis and renal failure requiring haemofiltration. Treatment withdrawn.
Patient 3	Patient undergoes OHTx on a background of post-partum cardiomyopathy, supported for 7 months on left ventricular assist device. Develops primary graft failure within 12 h requiring peripheral VA ECMO support.	Day 13: Weaned from peripheral VA ECMO and decannulated successfully	Day 20: Noticed to have bilateral lower limb paralysis. MRI revealed spinal cord infarction.	At 3 months: Develops sepsis and multiorgan failure and succumbs to it.