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. 2025 Jun 18:15:1588403.
doi: 10.3389/fonc.2025.1588403. eCollection 2025.

New perspectives on extracorporeal life support: expert teams and precise selection of candidates are transforming pediatric cancer and hematopoietic cell transplantation care

Caitlin Hurley  1   2 , Matteo Di Nardo  3 , Matthew Rees  4 , Diego R Hijano  5   6 , Ahmed Said  7   8 , Akshay Sharma  2 , Lama Elbahlawan  1 , Melissa R Hines  1   6 , Jennifer A McArthur  1 , Hitesh Sandhu  6   9   10 , Saad Ghafoor  1   6
Affiliations

New perspectives on extracorporeal life support: expert teams and precise selection of candidates are transforming pediatric cancer and hematopoietic cell transplantation care

Caitlin Hurley et al. Front Oncol. .

Abstract

Extra Corporeal Life Support (ECLS) for pediatric oncology and stem cell transplant patients over the past two decades has made progress. Substantial improvements in ECLS, Continuous Renal Replacement Therapy (CRRT), and mechanical ventilation techniques, along with enhanced anticoagulation management and infection control, have contributed to better patient outcomes. Additionally, advancements in HLA matching, donor selection, and the management of chemotherapy and transplant complications have further improved survival rates. The authors propose establishing an expert team and a standardized process to evaluate ECLS candidacy, addressing past controversies and optimizing outcomes for this vulnerable population. The criteria for candidacy have evolved significantly, necessitating expert evaluation.

Keywords: extracorporeal life support (ECLS); extracorporeal membrane oxygenation (ECMO); pediatric critical care; pediatric hematopoietic cell transplant; pediatric oncology.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

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