title: Intra-operative extracorporeal membrane oxygenation use in pediatric lung transplantation--the Zurich experience.
abstract: There is a lack of data regarding use of ECMO in children undergoing lung transplantation. We evaluated our experience of ECMO in pediatric lung transplant recipients. All patients (<18 yr) who underwent lung transplants between 1997 and 2011 were included (17 children; nine males; median age 16 yr), and the use of intra-operative ECMO evaluated. Transplant procedures were carried out with intra-operative ECMO in seven children (all bilateral lung transplants). Demographics of ECMO and non-ECMO patients were comparable. One child was already on ECMO pre-operative. Lung graft size reduction was undertaken in five ECMO and four non-ECMO cases, respectively. Five patients were taken off ECMO intra-operatively; the other patients were weaned off ECMO within 48 h post-operatively. Three-months survival was 100%. By 12 months post-transplantation, one patient each died in the ECMO and in the non-ECMO group. At the end of the study, six of seven ECMO cases were still alive (median survival 48.5 months); one patient required a retransplant at 53 months. Our small case series suggests that lung transplant procedures can be safely carried out in selected children on intra-operative ECMO support; however, our pediatric experience regarding this scenario is very limited but probably almost unique.
authors.affiliation: Division of Pulmonary Medicine, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Zuercher
authors.forename: Ilhan
authors.initials: I
authors.lastname: Inci
authors.forename: Christian
authors.initials: C
authors.lastname: Benden
authors.forename: Gregory
authors.initials: G
authors.lastname: Fretz
authors.forename: Markus
authors.initials: M
authors.lastname: Béchir
authors.forename: Annette
authors.initials: A
authors.lastname: Boehler
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000628:therapy*; D016040:Lung Transplantation; D008297:Male; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D013557:Switzerland; D016896:Treatment Outcome
keywords: children; extracorporeal membrane oxygenation; lung transplantation; pediatrics