{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:31:33Z","timestamp":1788229893589,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The use of veno\u2010arterial extracorporeal membrane oxygenation (VA\u2010ECMO) as a direct bridge to heart transplantation (BTT) is not common in adults worldwide. BTT with ECMO is associated with increased early\/mid\u2010term mortality compared with other interventions. In low\u2010 and middle\u2010income countries (LMIC), where no other type of short\u2010term mechanical circulatory support is available, its use is widespread and increasingly used as rescue therapy in patients with cardiogenic shock (CS) as a direct bridge to heart transplantation (HT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the outcomes of adult patients using VA\u2010ECMO as a direct BTT in an LMIC and compare them with international registries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a single\u2010center study analyzing consecutive adult patients requiring VA\u2010ECMO as BTT due to refractory CS or cardiac arrest (CA) in a cardiovascular center in Argentina between January 2014 and December 2022. Survival and adverse clinical events after VA\u2010ECMO implantation were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 86 VA\u2010ECMO, 22 (25.5%) were implanted as initial BTT strategy, and 52.1% of them underwent HT. Mean age was 46 years (SD 12); 59% were male. ECMO was indicated in 81% for CS, and the most common underlying condition was coronary artery disease (31.8%). Overall, in\u2010hospital mortality for VA\u2010ECMO as BTT was 50%. Survival to discharge was 83% in those who underwent HT and 10% in those who did not, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001. In those who did not undergo HT, the main cause of death was hemorrhagic complications (44%), followed by thrombotic complications (33%). The median duration of VA\u2010ECMO was 6 days (IQR 3\u201016). There were no differences in the number of days on ECMO between those who received a transplant and those who did not. In the Spanish registry, in\u2010hospital survival after HT was 66.7%; the United Network of Organ Sharing registry estimated post\u2010transplant survival at 73.1%\u00a0\u00b1\u00a04.4%, and in the French national registry 1\u2010year posttransplant survival was 70% in the VA\u2010ECMO group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In adult patients with cardiogenic shock, VA\u2010ECMO as a direct BTT allowed successful HT in half of the patients. HT provided a survival benefit in listed patients on VA\u2010ECMO. We present a single center experience with results comparable to those of international registries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15334","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T10:09:36Z","timestamp":1718186976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Veno\u2010arterial ECMO ventricular assistance as a direct bridge to heart transplant: A single center experience in a low\u2010middle income country"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3999-1265","authenticated-orcid":false,"given":"Lucrecia M.","family":"Burgos","sequence":"first","affiliation":[{"name":"Heart Failure Pulmonary Hypertension and Heart Transplant department Instituto Cardiovascular de Buenos Aires  Buenos Aires City Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorella 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C.","family":"Baro Vila","sequence":"additional","affiliation":[{"name":"Heart Failure Pulmonary Hypertension and Heart Transplant department Instituto Cardiovascular de Buenos Aires  Buenos Aires City Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda A.","family":"De Bortoli","sequence":"additional","affiliation":[{"name":"Heart Failure Pulmonary Hypertension and Heart Transplant department Instituto Cardiovascular de Buenos Aires  Buenos Aires City Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan F.","family":"Furmento","sequence":"additional","affiliation":[{"name":"Critical Cardiology Service Instituto Cardiovascular de Buenos Aires  Buenos Aires City Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P.","family":"Costabel","sequence":"additional","affiliation":[{"name":"Critical Cardiology Service Instituto Cardiovascular de Buenos Aires  Buenos Aires City 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