CASE REPORT article
Front. Transplant.
Sec. Abdominal Transplantation
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1683395
Application of Venovenous Extracorporeal Membrane Oxygenation Combined with Continuous Renal Replacement Therapy in a High-Risk Liver Transplant Recipient: A Case Report
Provisionally accepted
- People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Introduction: This report describes the novel perioperative application of VV-ECMO combined with CRRT in a high-risk liver transplant recipient with irreversible hypoxemia and multi-organ dysfunction, expanding therapeutic options for traditionally contraindicated patients. Case Presentation: A 27-year-old male with acute-on-chronic liver failure (chronic hepatitis B + alcoholic liver disease), hepatic encephalopathy, severe pulmonary infection, and coagulopathy developed life-threatening hypoxemia (PaO₂ 60 mmHg on FiO₂ 100%) during transplantation. Interventions: Emergency intraoperative VV-ECMO and postoperative CRRT were initiated. Outcomes: ECMO was withdrawn on postoperative day 4, the ventilator on day 11, and the patient was discharged on day 61. Follow-up showed normal liver function. Conclusion: Combined VV-ECMO/CRRT provides synergistic cardiopulmonary-renal support for high-risk liver transplants, creating a critical window for graft recovery. Multidisciplinary coordination is essential for success.
Keywords: ECMO, Liver Transplantation, Acute Respiratory Distress Syndrome, CRRT, case report
Received: 11 Aug 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 YANG, zhang and LU. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: yunli zhang, liyou@163.com
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