Management of primary graft dysfunction after lung transplantation with extracorporeal life support: an evidence-based review

: Primary graft dysfunction (PGD) is a complex inflammatory syndrome that can lead to respiratory failure after lung transplantation (LTx). The pathogenesis of PGD multifactorial and be driven by attributes both the donor recipient, perioperative characteristics, technical handling graft. Despite significant advancements in patient selection, management surgical technique, still major contributor morbidity mortality transplant. Although there are no known durable treatment options for LTx, an increasing body evidence experience high-volume transplant centers show extracorporeal life support (ECLS) reliable option preventing supporting critically ill patients with PGD. Both veno-venous (V-V) ECLS veno-arterial (V-A) proven feasible strategies mitigating associated post-LTx In this evidence-based review, we provide overview epidemiology physiology as well growing data supports tool manage We describe role ECMO prevention management, worldwide outcomes LTx support, outline our step-wise approach managing leading up institution ECLS.