Dual Extracorporeal Membrane Oxygenation Support for Bridging Lung Transplantation in Acute Exacerbation of Idiopathic Pulmonary Fibrosis

When patients with severe respiratory failure are treated with venovenous extracorporeal membrane oxygenation (VV-ECMO), severe pulmonary hypertension due to right ventricular (RV) failure is possible. This is a serious complication that requires immediate therapeutic intervention. We report an extraordinary experience of additional venoarterial extracorporeal membrane oxygenation (VA-ECMO) support for RV failure in a patient who was being treated with VV-ECMO as a bridge to lung transplantation. A 61-year-old man was diagnosed with acute exacerbation of idiopathic pulmonary fibrosis. While waiting for lung transplantation, he was placed on VV-ECMO and developed RV failure. After insertion of additional VA ECMO, RV dysfunction was dramatically improved. He underwent heart-lung transplantation after 23 days of dual ECMO support.