Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: The Extracorporeal Life Support experience

Background: Adults with cancer may be considered for extracorporeal life support (ECLS) as a means of support if failing conventional therapy. Methods: The Extracorporeal Life Support Organization Registry was queried for patients aged ≥21 years with diagnoses of malignancy or hematopoietic stem cell transplantation. Results: Seventy-two adults met inclusion criteria: 47 with solid tumors, 21 with hematologic malignancies, and 4 with hematopoietic stem cell transplantation. Patients required ECLS primarily for pulmonary support (n = 54). The median duration of ECLS was 4.1 days. Overall, 44 patients (61%) died on ECLS, 23 (32%) survived to hospital discharge, and 5 (7%) survived ECLS but died before discharge. Risk factors for death include pulmonary support as reason for ECLS, impaired lung function before ECLS, and development of infection. Conclusions: Adults with cancer can be offered ECLS with a small but real expectation for survival. Impaired pulmonary status and the development of infections are associated with death.