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Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 8

Successful lung transplant after prolonged Extracorporeal Membrane Oxygenation (ECMO) in a child with pulmonary hypertension: A case report

1 Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva, Switzerland
2 Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland
3 Institute of Anesthesiology, University Hospital of Zurich, Zurich, Switzerland

Correspondence Address:
Maurice Beghetti
Department of the Child and Adolescent, Children’s University Hospital of Geneva, Geneva
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Source of Support: None, Conflict of Interest: None

DOI: 10.5812/cardiovascmed.32545

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Introduction: The use of extracorporeal membrane oxygenation (ECMO) is considered a risk factor for, or even a potential con- traindication to, lung transplantation. However, only a few pediatric cases have been described thus far. Case Presentation: 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.

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