Extracorporeal Membrane Oxygenation for Lung Transplantation

Abstract

Extracorporeal membrane oxygenation (ECMO) has a clearly defined role in preoperative and postoperative transplant management of both heart and lung transplant. It is used on the recipient as a bridge to transplant, until the organs are made available. It provides a good support during surgery as a partial cardiopulmonary bypass. Posttransplant, it again provides support in case of an acute rejection or when graft dysfunction occurs, postoperatively. When ECMO as an indication is continued to provide support. Thus, ECMO has a positive impact on lung transplant outcomes.1 In a randomized control study, known as the CAESAR TRIAL in 2009, ECMO was confirmed as a definitive modern of treatment for ARDS.2 It gained the popularity for treating adult ARDS. Veith et al in 19773 reported that can be used as a support or as a bridge to lung transplant, with both short-term and long-term results. Thus, today in 2022, ECMO has emerged as a preferred modality of intraoperative support over conventional CPB.4 It was the reports of successful therapy of post graft dysfunction (PGD) with ECMO that prompted the use of ECMO intraoperatively. Currently, ECMO for lung transplant patients is the only rescue therapy to salvage a graft affected by severe PGD.