This retrospective single-center cohort included 100 consecutive heart transplant recipients grouped by pre-transplant support: ECMO, LVAD, or no mechanical circulatory support. Overall survival differed across groups (log-rank P = 0.001), mainly reflecting worse survival with ECMO than without mechanical support. Survival did not significantly differ between the ECMO and LVAD groups. Postoperative continuous renal replacement therapy and other markers of organ dysfunction were more frequent in the ECMO group, which the authors interpreted as reflecting greater illness severity.
Pre-transplant ECMO was associated with worse post-transplant survival than no mechanical support. These findings do not establish an independent effect of ECMO, and the ECMO–LVAD comparison remains inconclusive.
Study limitation: The retrospective single-center design and small LVAD group limit causal interpretation and precision of between-support comparisons.
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