Successful Heart Transplantation Recovered From a Brain-Dead Donor on Veno-Arterial Extracorporeal Membrane Oxygenation Support

We describe the successful transplantation of a brain-dead donor supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac arrest secondary to pulmonary embolism. The donor was a 50-year-old female who developed massive pulmonary embolism complicated by cardiac arrest requiring initiation of VA-ECMO. An initial echocardiogram revealed severe right ventricular dysfunction which recovered after 6 days of VA-ECMO confirmed by transthoracic echocardiogram and right heart catheterization. The heart was transplanted to a 56-year-old male on a left ventricular assist device. At 1-year posttransplant, he continues to have normal graft function. The present case reports the successful transplantation of a brain-dead donor heart recently recovered from pulmonary embolism induced acute right ventricular failure supported by VA-ECMO and represents a potential source of increased donor organs that would otherwise not be utilized.