We present a 29-year-old male Jehovah's Witness, who underwent a second orthotopic heart transplantation 20 years after his first transplant. After extubation, the patient aspirated and required support with extracorporeal membrane oxygenation (ECMO). During the period of ECMO support, his hemoglobin decreased to 4.7 mg/dl. The patient was ultimately weaned from ECMO and discharged home. To our knowledge, this is the first reported case of 1) heart retransplantation and 2) rescue with ECMO in a Jehovah's Witness patient.