Temporary ECMO support following lung and heart-lung transplantation

Following lung and heart-lung transplantation, pulmonary graft failure unresponsive to aggressive conventional therapy may be fatal. Fourteen transplant recipients were placed on extracorporeal membrane oxygenation (ECMO) for pulmonary graft dysfunction. Nine patients had early (less than or equal to 24 hours) graft failure while 5 had late (> 7 days) failure. Seven (78%) patients in the early group were weaned off ECMO and 5 (56%) survived to hospital discharge. In the late group, none of the patients could be weaned off ECMO, yielding 100% mortality. ECMO support instituted for pulmonary graft failure that occurred within 24 hours of transplantation may improve patient survival.