[Extracorporeal Membrane Oxygenation in Lung Transplantation]

Area of Science:

• Cardiovascular Medicine
• Pulmonary Medicine
• Transplant Surgery

Background:

• Lung transplantation is a complex procedure with potential complications.
• Extracorporeal membrane oxygenation (ECMO) is increasingly utilized in managing lung transplant patients.
• Various clinical scenarios necessitate ECMO support during the lung transplantation journey.

Purpose of the Study:

• To review the indications for ECMO in lung transplantation.
• To discuss the different types of ECMO required for specific complications.
• To present institutional experience and literature review on ECMO in lung transplantation.

Main Methods:

• Case series describing five patients bridged to lung transplantation with ECMO.
• Review of literature on ECMO use in lung transplantation.
• Analysis of eight patients with pulmonary arterial hypertension receiving perioperative ECMO.

Main Results:

• Successful bridging to lung transplantation using ECMO in five cases, including living donor transplants.
• Uneventful postoperative courses for eight patients with pulmonary arterial hypertension supported by ECMO.
• ECMO effectively managed intraoperative support, primary graft dysfunction, rejection, infection, and pulmonary arterial hypertension.

Conclusions:

• ECMO is a versatile tool in lung transplantation, applicable before, during, and after the procedure.
• ECMO facilitates recovery from reversible respiratory failure and aids cardiovascular adaptation post-transplant.
• The strategic use of ECMO improves outcomes for complex lung transplant cases, including those with pulmonary arterial hypertension.