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Review
. 2021 Jul 18;11(7):290-302.
doi: 10.5500/wjt.v11.i7.290.

Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results

Eleonora Faccioli  1 , Stefano Terzi  1 , Alessandro Pangoni  1 , Ivan Lomangino  1 , Sara Rossi  1 , Andrea Lloret  1 , Giorgio Cannone  1 , Carlotta Marino  1 , Chiara Catelli  1 , Andrea Dell'Amore  2
Affiliations
Review

Extracorporeal membrane oxygenation in lung transplantation: Indications, techniques and results

Eleonora Faccioli et al. World J Transplant. .

Abstract

The use of extracorporeal membrane oxygenation (ECMO) in the field of lung transplantation has rapidly expanded over the past 30 years. It has become an important tool in an increasing number of specialized centers as a bridge to transplantation and in the intra-operative and/or post-operative setting. ECMO is an extremely versatile tool in the field of lung transplantation as it can be used and adapted in different configurations with several potential cannulation sites according to the specific need of the recipient. For example, patients who need to be bridged to lung transplantation often have hypercapnic respiratory failure that may preferably benefit from veno-venous (VV) ECMO or peripheral veno-arterial (VA) ECMO in the case of hemodynamic instability. Moreover, in an intra-operative setting, VV ECMO can be maintained or switched to a VA ECMO. The routine use of intra-operative ECMO and its eventual prolongation in the post-operative period has been widely investigated in recent years by several important lung transplantation centers in order to assess the graft function and its potential protective role on primary graft dysfunction and on ischemia-reperfusion injury. This review will assess the current evidence on the role of ECMO in the different phases of lung transplantation, while analyzing different studies on pre, intra- and post-operative utilization of this extracorporeal support.

Keywords: Bridge to transplantation; Extracorporeal membrane oxygenation; Ischemia-reperfusion injury; Lung transplantation; Primary graft dysfunction; Support.

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Conflict of interest statement

Conflict-of-interest statement: Authors have nothing to disclose.

Figures

Figure 1
Figure 1
Different extra-corporeal membrane oxygenation configurations. A: Veno-venous extra-corporeal membrane oxygenation (ECMO) with jugular cannulation; B: Veno-arterial ECMO with peripheral cannulation, with the cannula for distal perfusion of the leg; C: Veno-arterial ECMO with central cannulation, the blood is drained from the right atrium and reinfused into the aorta; D: Central bicaval veno-arterial ECMO configuration.
See this image and copyright information in PMC

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