Successful use of veno-venous extracorporeal membrane oxygenation as a bridge to lung T transplantation in a patient with pulmonary fibrosis

As the Japanese organ donor allocation system does not permit the allocation of lungs at a priority level to patients on extracorporeal membrane oxygenation (ECMO), many of these patients die before suitable donor lungs become available. We report our first experience with ECMO as a bridge to lung transplantation (LTx) from a brain-dead donor. A 40-year-old man with interstitial lung disease who was listed for LTx 3 years previously, experienced progressive deterioration of respiratory function. He was mechanically ventilated at another hospital and was transported to our hospital due to severe hypoxemia. He underwent veno-venous ECMO and was extubated 2 h after the ECMO therapy was initiated. He was conscious, could consume food and liquids, and could exercise normally while awaiting LTx. Lungs from a marginal donor became available on day 18 after ECMO initiation. He was transported to the transplantation center and successfully underwent LTx.