An 18-year-old girl with high risk acute myeloid leukemia developed Streptococcus mitis septic shock and multi-organ dysfunction syndrome, including biventricular failure. Due to the anticipated reversibility of her cardiogenic shock, her young age and her favorable survival chance following allogeneic hematopoietic stem cell transplant, she was placed on full circulatory support with veno-arterial extracorporeal membrane oxygenation as a bridge to her successful HSCT two months later. This highlights the importance of prognostication in patient selection for extracorporeal life support. A multi-disciplinary approach is essential to each case until better initiation criteria, risk stratification and treatment protocols are established.