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Review
. 2021 Sep;37(Suppl 3):476-483.
doi: 10.1007/s12055-021-01175-4. Epub 2021 Apr 27.

Extracorporeal life support during lung transplantation

Jenalee Nicole Coster  1 , Gabriel Loor  2   3
Affiliations
Review

Extracorporeal life support during lung transplantation

Jenalee Nicole Coster et al. Indian J Thorac Cardiovasc Surg. 2021 Sep.

Abstract

Lung transplantation surgeries are performed without extracorporeal life support (ECLS) by using an off-pump technique; however, in cases of hypoxemia or hemodynamic instability, intraoperative ECLS may be required. Cardiopulmonary bypass (CPB) has traditionally been the standard practice for ECLS but has been associated with an increased risk of bleeding in the perioperative period, increased transfusion requirements, prolonged postoperative intubation, and possibly primary graft dysfunction. More recently, because of the flexibility of using extracorporeal membrane oxygenation (ECMO) in bridging to transplantation and during postoperative recovery, its use has increased. CPB and ECMO each has advantages and disadvantages; however, because comparisons of CPB and ECMO have been limited to small retrospective observational and single-institution studies, more research is required to determine the superiority of one modality. In this review, we critically examine the pros and cons of performing lung transplantation surgery off-pump or by using the ECLS modalities of ECMO and CPB support during lung transplantation surgery.

Keywords: Cardiopulmonary bypass; ECMO; Extracorporeal life support; Lung transplantation.

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Conflict of interest statement

Conflict of interestDr Gabriel Loor is a consultant for Abiomed. Institution receives grant support for ECMO and cardiothoracic research from Maquet, Medtronic, Transmedics, and St. Jude.

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