Related Experiment Video
Updated: Mar 6, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Development of a new interfacility extracorporeal membrane oxygenation transport program for pediatric lung
W Joshua Frazier1, Edward G Shepherd2, Samantha W Gee3
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA.
Insights
Transporting children on extracorporeal membrane oxygenation (ECMO) to specialized centers for lung transplantation is feasible. This service improves access to life-saving lung transplant evaluations for critically ill pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Cardiopulmonary transplantation
- Medical transport services
Background:
- Pediatric lung transplantation is crucial for end-stage lung disease but access is limited by geography and comorbidities.
- Extracorporeal membrane oxygenation (ECMO)-supported patients represent a high-risk group for lung transplantation.
- Geographic isolation and local inability to manage ECMO can prevent transplant evaluation.
Purpose of the Study:
- To establish a dedicated transport service for ECMO-dependent pediatric patients.
- To facilitate access to lung transplant evaluation for critically ill children.
- To overcome logistical barriers hindering transplant access for isolated or complex cases.
Main Methods:
- Developed a pre-transport consultation process with a lung transplant physician team.
- Created standardized patient hand-off tools and equipment checklists.
- Established procedures for transitioning patients to transport ECMO systems.
- Utilized fixed-wing and helicopter transport for four patients.
Main Results:
- Successfully transported four pediatric patients supported by ECMO.
- Transports involved fixed-wing and helicopter modalities.
- All patients experienced none or only minor complications during transport.
- The service demonstrated feasibility in managing high-risk pediatric patients.
Conclusions:
- Transporting ECMO-supported pediatric patients to a specialized center is a viable strategy.
- This service can significantly increase access to lung transplant evaluations.
- Overcoming transport challenges enhances opportunities for children with irreversible lung injury.
Abstract:
Pediatric lung transplantation is a life-saving intervention for children with irreversible end-stage lung disease. Access to transplant can be limited by geographic isolation from a center or the presence of comorbidities affecting transplant eligibility. Extracorporeal membrane oxygenation (ECMO)-supported patients are an uncommon but historically high-risk cohort of patients considered for lung transplant. We report the development of a service at our center to provide transport services to our hospital for patients unable to wean from ECMO support at their local institution for the purpose of evaluation for lung transplantation by our program. We developed a process for pre-transport consultation by the lung transplant physician team, standardized hand-off tools and equipment lists, and procedures for transitioning patients to transport ECMO machinery. Four patients have been transported to date including fixed wing (FW) and helicopter transports. All patients were successfully transported with either none or minor complications. Transport of ECMO-supported patients is a feasible method to increase access of patients with irreversible lung injured patients to evaluation for lung transplant.
