A case of severe respiratory failure due to interstitial pneumonia successfully bridged to lung transplantation from a brain-dead donor using 109-day veno-arterial extracorporeal membrane oxygenation

We present the case of a man in his thirties, diagnosed with interstitial pneumonia 6  years prior and registered for lung transplant 1 year prior due to disease progression despite treatment. Due to the patient’s worsening respiratory failure, he was transferred to our hospital for BTT by ECMO. Since long-term management was expected and pulmonary hypertension was present, veno- arterial (V-A) ECMO was conducted using the right atrial blood outflow via the right internal jugular vein and right axillary artery inflow via a vascular graft. After tracheostomy, he was managed as “Awake ECMO”. In addition, interprofessional collaboration such as physiotherapist rehabilitatio n, nurses, and liaison teams prevented muscle weakness and supported the mental aspect. We were able to minimize complications such as severe infections and bleeding. A compatible brain-dead donor was found on day 108 after introducing ECMO, and the patient was transferred to a transplant facility o n day 109. The peripheral upper V-A ECMO is one of the configurations suitable for long-term BTT management.
Source: Journal of Artificial Organs - Category: Transplant Surgery Source Type: research