successful lung transplant after prolonged extracorporeal membrane oxygenation (ecmo) in a child with pulmonary hypertension: a case report

cecile tissot department of the child and adolescent, children’s university hospital of geneva, geneva, switzerland, walid habre department of the child and adolescent, children’s university hospital of geneva, geneva, switzerland, paola soccal division of pneumology, university hospital of geneva, geneva, switzerland, maja isabel hug institute of anesthesiology, university hospital of zurich, zurich, switzerland, dominique bettex institute of anesthesiology, university hospital of zurich, zurich, switzerland, michel pellegrini department of the child and adolescent, children’s university hospital of geneva, geneva, switzerland

چکیده

conclusions increasing evidence supports the use of ecmo as a bridge to lt, reporting good outcomes. in the modern era of pah therapy, it is feasible to use prolonged ecmo support as a bridge to lung transplant, with the aim of weaning off this support; however, its use requires more experience and knowledge of long-term outcomes. introduction the use of extracorporeal membrane oxygenation (ecmo) is considered a risk factor for, or even a potential contraindication to, lung transplantation. however, only a few pediatric cases have been described thus far. case presentation a 9-year-old boy with idiopathic pulmonary arterial hypertension developed cardiac arrest after the insertion of a central catheter. ecmo was used as a bridge to lung transplantation. however, after prolonged resuscitation, he developed medullary ischemia and medullary syndrome. after 6 weeks of ecmo and triple combination therapy for pulmonary hypertension, including continuous intravenous prostacyclin, he was weaned off support, and after 2 weeks, bilateral lung transplantation was performed. at 4 years post-transplant, he has minimal problems. the medullary syndrome has also alleviated. he is now back to school and can walk with aids.