Heart Recovery from a Brain-Dead Donor on Venoarterial Extracorporeal Membrane Oxygenation Support After Massive Pulmonary Embolism: Possibility to Maximize Organ Availability

Abstract

We appreciate the letter from Banfi et al. 1 regarding our manuscript in which we reported the successful transplantation of a brain-dead donor (BDD) supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac arrest secondary to pulmonary embolism. 2 VA-ECMO has been shown to effectively treat massive PE associated with right ventricular (RV) failure and many patients achieve full RV recovery without additional extirpative procedures. 3,4 Unfortunately, some patients suffer from irreversible brain injury during resuscitation despite recovery of RV function like the present case. 2 The most challenging part of heart recovery from a BDD on VA-ECMO is the evaluation of the heart function. There are several options of organ recovery when a BDD is on VA-ECMO: