Extended Bridge to Heart and Lung Transplantation Using Pumpless Extracorporeal Lung Assist

In end-stage idiopathic pulmonary artery hypertension (iPAH), centrally cannulated Novalung (Novalung GmbH, Hechingen, Germany) pumpless extracorporeal lung assist (pECLA) decompresses the pulmonary artery for bridge to transplantation. We report placing a 45-year-old man with end-stage iPAH and right heart failure on centrally cannulated pECLA for 82 days as a bridge to heart and double-lung transplantation (HLTx). To our knowledge, this is the longest reported bridge to transplantation in Canada and the first successful bridge to HLTx. We demonstrate how pECLA permits mobility, facilitating physiotherapy to ensure fitness for transplantation. Considering the irreversible right heart failure, HLTx remains suitable in iPAH.