Extracorporeal Membrane Oxygenation to Overcome Graft-Cavity Disparity of Lung Transplantation

The waitlist mortality rate is higher in patients with severe restrictive pulmonary disease because of the rapid clinical progression of the disease and the challenges of finding lung allografts that fit their small chest cavities in a timely manner. This report describes a case of urgent lung transplantation in which venovenous extracorporeal membrane oxygenation was used after open chest management and volume reduction to allow the lung allograft to accommodate to a smaller chest cavity. The use of venovenous extracorporeal membrane oxygenation in this case facilitated early chest closure in a patient with graft-cavity disparity while lowering the risk of infection without hemodynamic or respiratory compromise.