Lung Re‐transplantation after prolonged veno‐venous extracorporeal membrane oxygenation (ECMO) in a child with chronic lung allograft dysfunction

Abstract

AbstractBackgroundExtracorporeal 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.MethodsWe 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).ResultsEarly rehabilitation was key in improving the overall pre‐transplant conditioning during ECMO.ConclusionsDespite 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.