ECMO in Pediatric Lung Transplantation

Pediatric extracorporeal membrane oxygenation (ECMO) or mechanical ventilation have previously been considered significant risk factors in lung transplantation in adults and children. Due to attrition while awaiting organs, strategies have become increasingly focused on extending the life of potential lung transplant (LTx) candidates by means of ECMO as a “bridge” to transplantation. Some transplant centers, however, consider mechanical ventilation and/or ECMO prior to lung transplant a contraindication, or relative contraindication, because of perceived postoperative complications, decreased 1-year survival, and concern for sensitization from increased blood transfusion requirements. The chapter focuses on this controversy specifically related to lung transplantation in children.