title: Successful Lung Transplant After Prolonged Extracorporeal Membrane Oxygenation (ECMO) in a Child With Pulmonary Hypertension: A Case Report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  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.
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Cecile
authors: C
authors: Tissot
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Walid
authors: W
authors: Habre
authors: Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland.
authors: Paola
authors: P
authors: Soccal
authors: Institute of Anesthesiology, University Hospital of Zurich, Zurich, Switzerland.
authors: Maja Isabel
authors: MI
authors: Hug
authors: Institute of Anesthesiology, University Hospital of Zurich, Zurich, Switzerland.
authors: Dominique
authors: D
authors: Bettex
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Michel
authors: M
authors: Pellegrini
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Yacine
authors: Y
authors: Aggoun
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Anne
authors: A
authors: Mornand
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Afksendyios
authors: A
authors: Kalangos
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Peter
authors: P
authors: Rimensberger
authors: Department of the Child and Adolescent, Children's University Hospital of Geneva, Geneva, Switzerland.
authors: Maurice
authors: M
authors: Beghetti
keywords: Extracorporeal Membrane Oxygenation (ECMO); Hypertension, Pulmonary; Lung Transplantation; Pediatrics