Allogeneic Hematopoietic Stem Cell Transplant Infusion During Venovenous Extracorporeal Membrane Oxygenation Support

Crit Care Explor. 2021 Oct 8;3(10):e551. doi: 10.1097/CCE.0000000000000551. eCollection 2021 Oct.

Abstract

Management of hematopoietic stem cell transplant complicated by respiratory failure has been facilitated by the use of extracorporeal membrane oxygenation as a bridge to curative chemotherapeutic options. This is the first report of hematopoietic stem cell transplantation on extracorporeal membrane oxygenation in the adult population.

Case summary: A 28-year-old woman diagnosed with idiopathic aplastic anemia complicated by acute respiratory distress syndrome secondary to pneumonia required venovenous extracorporeal membrane oxygenation to supplement oxygenation and ventilation. She received hematopoietic stem cell transplantation while she was on extracorporeal membrane oxygenation support.

Main results and conclusion: Delivery of the stem cell through extracorporeal membrane oxygenation circuit was successful in the described patient. There was no sequestered stem cell in extracorporeal membrane oxygenation circuit, and she was found to have 90% donor chimerism suggesting successful engraftment. This report showed that infusion of stem cell through extracorporeal membrane oxygenation circuit is safe and feasible, and our results suggest that successful engraftment is possible.

Keywords: acute respiratory distress syndrome; aplastic anemia; engraftment; extracorporeal life support; extracorporeal membrane oxygenation; hematopoietic stem cell transplantation.

Publication types

  • Case Reports