First experience with a paracorporeal artificial lung in humans

Area of Science:

• Cardiovascular Engineering
• Pulmonary Medicine
• Medical Devices

Background:

• Lung transplantation is the sole definitive treatment for end-stage respiratory failure.
• Current mechanical circulatory support options are limited for patients awaiting lung transplantation for extended periods.

Observation:

• Two patients with end-stage respiratory failure were supported using a paracorporeal artificial lung (PAL) system.
• The PAL, featuring a low-resistance membrane oxygenator (iLA), was connected in parallel to the pulmonary circulation.
• Support durations were 18 days for the first patient (pulmonary veno-occlusive disease) and 62 days for the second (primary pulmonary hypertension).

Findings:

• The first patient succumbed to sepsis despite PAL support.
• The second patient, supported by PAL, successfully underwent lung transplantation.
• The paracorporeal artificial lung demonstrated feasibility for bridging patients to lung transplantation.

Implications:

• This early experience with PAL suggests its potential as a viable bridging strategy for lung transplant candidates.
• Further clinical studies are warranted to optimize PAL use and expand its application in managing respiratory failure.
• The development of effective mechanical support devices like PAL could significantly improve outcomes for patients awaiting lung transplantation.