title: Buying time: The use of extracorporeal membrane oxygenation as a bridge to lung transplantation in pediatric patients.
abstract: To describe our experience to date of four children with end-stage lung disease who have been bridged with ECMO to successful lung transplantation in our institution. Between March 2006 and June 2012, a total of 21 pediatric patients successfully underwent lung transplantation within The Alfred's lung transplantation program. This included four children who were bridged on ECMO prior to transplantation according to the "ECMO bridge to transplant" protocol and whose clinical notes and outcomes were reviewed. Lung transplantation is an established life-saving treatment for patients with severe lung disease, but remains limited due to scarcity of suitable donor organs. This is a particular issue in the pediatric setting, where the smaller child waits disproportionately longer compared with adult patients for size-matched donor lungs. As ECMO has become more widely accepted, its use as a bridge to lung transplantation in pediatric patients with severe acute lung injury or end-stage chronic lung disease has been considered. The medical notes from the four pediatric patients were retrospectively reviewed. Our report describes excellent short- and medium-term outcomes in a small number of children who have been bridged to transplant on ECMO.
authors.affiliation: Lung Transplant Service, National Funded Centre for Paediatric Lung Transplantation, The Alfred Hospital, Melbourne, Vic., Australia.
authors.forename: Georgina K
authors.initials: GK
authors.lastname: Casswell
authors.forename: David V
authors.initials: DV
authors.lastname: Pilcher
authors.forename: Rani S
authors.initials: RS
authors.lastname: Martin
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Pellegrino
authors.forename: Silvana F
authors.initials: SF
authors.lastname: Marasco
authors.forename: Colin
authors.initials: C
authors.lastname: Robertson
authors.forename: Warwick
authors.initials: W
authors.lastname: Butt
authors.forename: Mark
authors.initials: M
authors.lastname: Buckland
authors.forename: Julian
authors.initials: J
authors.lastname: Gooi
authors.forename: Gregory I
authors.initials: GI
authors.lastname: Snell
authors.forename: Glen P
authors.initials: GP
authors.lastname: Westall
mesh_terms: D055371:Acute Lung Injury / Q000628:therapy; D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000628:therapy; D004417:Dyspnea / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008168:Lung / Q000601:surgery; D008171:Lung Diseases / Q000628:therapy*; D016040:Lung Transplantation; D016896:Treatment Outcome
keywords: cystic fibrosis; extracorporeal membrane oxygenation; lung transplantation; pediatric; pulmonary arterial hypertension