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Updated: Jul 23, 2025
Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
Published on: February 14, 2022
Lung Re-transplantation after prolonged veno-venous extracorporeal membrane oxygenation (ECMO) in a child with
Andres Herrera-Camino1,2, Stuart C Sweet2, Rebecca Pendino3
1Division of Pediatric Critical Care Medicine, Washington University in St. Louis, St Louis, Missouri, USA.
Background:
Extracorporeal Membrane Oxygenation (ECMO) may be used as a bridge to lung transplantation in selected patients with end-stage respiratory failure. Historically, ECMO use in this setting has been associated with poor outcomes Puri V et.al, J Thorac Cardiovasc Surg, 140:427. More recently, technical advances and the implementation of rehabilitation and ambulation while awaiting transplantation on ECMO have led to improved surgical and post-transplant outcomes Kirkby S et.al, J Thorac Dis, 6:1024.
Methods:
We illustrate the case of a 6-year-old child who received prolonged ECMO support as a bridge to lung re-transplantation secondary to Chronic Lung Allograft Dysfunction (CLAD).
Results:
Early rehabilitation was key in improving the overall pre-transplant conditioning during ECMO.
Conclusions:
Despite challenges associated with awake/ambulatory ECMO, the use of this strategy as a bridge to lung transplantation is feasible and has resulted in improved pre-transplant conditioning and post-transplant outcomes.
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