Escalation of extracorporeal life support as a bridge to lung transplantation in end-stage lung disease

Extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplant (LTx) is not uncommon, but it is not commonplace yet. We present a case of a 45-year-old man with cystic fibrosis with recent deterioration in lung function who was initially supported with veno-venous (VV) ECMO. However, he subsequently required conversion to veno-veno-arterial (VVA) ECMO. After 21 days of support, he underwent double lung transplantation, with an uneventful postoperative course. This case shows that, in patients with end-stage respiratory failure awaiting lung transplantation, extracorporeal life support may require escalation to improve gas exchange and address circulatory requirements.

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Bone involvement in young adults with cystic fibrosis awaiting lung transplantation for end-stage respiratory failure

Osteoporosis International ◽

10.1007/s00198-019-04893-z ◽

2019 ◽

Vol 30 (6) ◽

pp. 1255-1263 ◽

Cited By ~ 7

Author(s):

E. Cairoli ◽

C. Eller-Vainicher ◽

L.C. Morlacchi ◽

P. Tarsia ◽

V. Rossetti ◽

...

Keyword(s):

Cystic Fibrosis ◽

Young Adults ◽

Respiratory Failure ◽

Lung Transplantation ◽

Bone Involvement ◽

End Stage

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13: Extracorporeal life support is a viable bridge to lung transplantation in patients with acute cor pulmonale and end stage pulmonary fibrosis: A case series

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2006.11.027 ◽

2007 ◽

Vol 26 (2) ◽

pp. S65

Author(s):

J.K. Wall ◽

J. Parekh ◽

S. Hays ◽

J.A. Golden ◽

C. Hoopes

Keyword(s):

Pulmonary Fibrosis ◽

Lung Transplantation ◽

Life Support ◽

Extracorporeal Life Support ◽

Case Series ◽

Cor Pulmonale ◽

Acute Cor Pulmonale ◽

End Stage

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WS8.3 Extracorporeal life support as a bridge to lung transplantation: outcome in cystic fibrosis recipients

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(14)60054-0 ◽

2014 ◽

Vol 13 ◽

pp. S17

Author(s):

I. Inci ◽

U. Bürgi ◽

C. Benden ◽

L.C. Huber ◽

P. Kestenholz ◽

...

Keyword(s):

Cystic Fibrosis ◽

Lung Transplantation ◽

Life Support ◽

Extracorporeal Life Support

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ECCO2R as a bridge to a decision in type II respiratory failure

Acta medica Lituanica ◽

10.6001/actamedica.v26i1.3962 ◽

2019 ◽

Vol 26 (1) ◽

pp. 101-106

Author(s):

Lina Grauslytė ◽

Gonzalo De La Cerda ◽

Tomas Jovaiša

Keyword(s):

Decision Making ◽

Case Report ◽

Respiratory Failure ◽

End Of Life ◽

Lung Transplant ◽

Life Support ◽

Support Systems ◽

Extracorporeal Life Support ◽

Life Support Systems ◽

End Of Life Decisions

Introduction. End-of-life decisions are often time consuming and difficult for everyone involved. In some of these cases extracorporeal life support systems could potentially be used not only as a bridge to treatment but as a tool to buy time to allow patient’s participation in decision making and to avoid further futile invasive procedures. Case report. A previously healthy 53-year-old female patient presented with respiratory failure of unknown cause. In the course of treatment her condition was deemed irreversible and the only option for any chance of long-term survival was a lung transplant. During this whole time the patient’s condition was managed with extracorporeal carbon dioxide removal system (ECCO2R). She remained compos mentis and expressed the wish to stop all the treatment as the option of lung transplant was not acceptable to her. Treatment was withdrawn and she passed away. Discussion. In cases of end-of-life decisions, time can play an essential role. Even though extracorporeal life support systems have been conceptualised to be a bridge to treatment, they could be beneficial in a situation when time is needed to make a decision. ECCO2R has been used as a treatment method in different settings, however, in this case it served as a tool to maintain the patient alive and conscious for a sufficient time for her to participate in decision making. Conclusions. Our case report demonstrated that ECCO2R could serve as a bridge to decision in situations when time is limited and the decisions that need to be made are difficult.

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