ECMO as bridge to lung transplant

Since the advent of lung transplantation more than 5 decades ago, preoperative, surgical, and anesthetic management have improved. The growing experience with extracorporeal membrane oxygenation (ECMO) has enabled clinicians to expand its effective use to care for patients while bridging them to transplant (BTT). We highlight the approach in which ECMO is used to successfully bridge critically ill patients to lung transplantation when stringent daily clinical assessment is applied. In patients who continued to meet transplant criteria and were successfully transplanted, postoperative survival rates are acceptable. Larger studies are needed to inform decision algorithms for BTT patients and optimize outcomes.