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Extended use of extra corporeal membrane oxygenation as bridge to lung transplantation in two patients

Journal article
Authors Elin Skansebo
M. Broome
Jesper Magnusson
Gerdt C. Riise
Göran Dellgren
Published in Journal of Cardiothoracic Surgery
Volume 15
Issue 1
ISSN 1749-8090
Publication year 2020
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Institute of Biomedicine, Department of Medical Biochemistry and Cell Biology
Institute of Medicine, Department of Molecular and Clinical Medicine
Language en
Links dx.doi.org/10.1186/s13019-020-1046-...
Keywords Lung transplantation, ECMO, Mechanical circulatory support, Cardiovascular System & Cardiology
Subject categories Cardiovascular medicine

Abstract

Background We have previously reported our outcome after extra-corporeal membrane oxygenation as bridge-to-lung transplantation, which initially was considered controversial, but over time have gained acceptance and now is performed in most high-volume institutions. Case presentation We now report two "extreme" extra-corporeal membrane oxygenation (ECMO) bridge-to-lung transplantation cases, on ECMO > 200 days prior to lung transplantation. One patient survived long-term and the other one did not, and clinical cause and morbidity is outlined in this case-report. Conclusion We believe these two cases highlight the medical, ethical and resource allocation difficulties involved with saving patients in very dire circumstances. We have shown that a patient can survive extremely long duration of ECMO bridge to lung transplantation, but selection remains crucial to achieve a reasonable cost-benefit.

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