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A case of severe respiratory failure due to interstitial pneumonia successfully bridged to lung transplantation from a brain-dead donor using 109-day veno-arterial extracorporeal membrane oxygenation

  • Case Report
  • Artificial Lung / ECMO
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Abstract

In Japan, successful cases of a bridge to lung transplantation (BTT) by extracorporeal membrane oxygenation (ECMO) are rare. We present the case of a man in his thirties, diagnosed with interstitial pneumonia 6 years prior and registered for lung transplant 1 year prior due to disease progression despite treatment. Due to the patient’s worsening respiratory failure, he was transferred to our hospital for BTT by ECMO. Since long-term management was expected and pulmonary hypertension was present, veno-arterial (V-A) ECMO was conducted using the right atrial blood outflow via the right internal jugular vein and right axillary artery inflow via a vascular graft. After tracheostomy, he was managed as “Awake ECMO”. In addition, interprofessional collaboration such as physiotherapist rehabilitation, nurses, and liaison teams prevented muscle weakness and supported the mental aspect. We were able to minimize complications such as severe infections and bleeding. A compatible brain-dead donor was found on day 108 after introducing ECMO, and the patient was transferred to a transplant facility on day 109. The peripheral upper V-A ECMO is one of the configurations suitable for long-term BTT management.

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Acknowledgements

TI: is currently affiliated with the Emergency and Critical Care Medical Center, Yamanashi Prefectural Central Hospital. SI: is currently affiliated with the Department of Clinical Engineering and Department of Intensive Care Medicine, Tokyo Women’s Medical University Hospital.

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Authors and Affiliations

  1. Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital, Tokyo, Japan

    Tokuji Ikeda & Shingo Ichiba

  2. Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan

    Takashi Sasaki

  3. Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan

    Masaaki Sato, Chihiro Konoeda & Jun Nakajima

  4. Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan

    Tsukasa Okamoto & Yasunari Miyazaki

  5. Department of Anesthesiology, Nippon Medical School, Tokyo, Japan

    Tokuji Ikeda, Shingo Ichiba & Atsuhiro Sakamoto

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  1. Tokuji Ikeda
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  2. Shingo Ichiba
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  3. Takashi Sasaki
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  4. Masaaki Sato
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  5. Chihiro Konoeda
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  6. Tsukasa Okamoto
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  7. Yasunari Miyazaki
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  8. Jun Nakajima
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  9. Atsuhiro Sakamoto
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Correspondence to Tokuji Ikeda or Shingo Ichiba.

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Ikeda, T., Ichiba, S., Sasaki, T. et al. A case of severe respiratory failure due to interstitial pneumonia successfully bridged to lung transplantation from a brain-dead donor using 109-day veno-arterial extracorporeal membrane oxygenation. J Artif Organs 26, 84–88 (2023). https://doi.org/10.1007/s10047-022-01341-4

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  • DOI: https://doi.org/10.1007/s10047-022-01341-4

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