Anesthetic considerations for perioperative ECMO in lung transplantation

The care for lung transplantation patients is a complex, multidisciplinary coordination of physician and non-physician teams throughout the perioperative period. The diversity of etiologies of recipient end-stage lung disease further complicate care, as recipients often present with concomitant end-stage cardiac disease. Recently, the use of extracorporeal membrane oxygenation has become the mechanical circulatory support of choice to provide cardiopulmonary stability throughout the perioperative period. This review will focus specifically on the anesthetic considerations for perioperative extracorporeal membrane oxygenation in lung transplantation throughout preoperative bridge to transplantation, intraoperative management, and postoperative utilization.