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ECMO as a Bridge to Lung Transplantation

  • Christian A. BermudezEmail author
  • JaBaris D. Swain
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Extracorporeal membrane oxygenation (ECMO) has evolved as an excellent alternative to support patients with end-stage lung disease until viable donated lungs become available for transplantation. Over the last decade, key innovations have enhanced the attractiveness of ECMO as a suitable bridging platform to lung transplant, thereby expanding the possibilities available to select patients. ECMO cannulation strategies can be adjusted according to the needs of the patient, and typically veno-venous ECMO is employed. The findings of retrospective series over the last 8 years have made it clear that less than ideal outcomes after ECMO support should not be a deterrent to pretransplant ECMO support in patients who require a bridge to lung transplantation. As ECMO technology improves, ECMO support without invasive mechanical ventilation and sedation has been applied an increasing number of patients. Newer veno-venous cannulation strategies utilizing a single, dual-lumen ECMO cannula allow the possibility of mobilization and rehabilitation.

Keywords

Artificial respiration Extracorporeal membrane oxygenation Lung transplantation 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Cardiovascular SurgeryHospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of SurgeryUniversity of Pennsylvania School of MedicinePhiladelphiaUSA

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