Extracorpoeal membrane oxygenation support for single-lung transplantation in patients with primary pulmonary hypertention.

Due to the advantages of optimal use of donor organs and relative simplicity of the surgical procedure, single lung transplantation (SLTx) has become the preferred transplantation procedure for end-stage primary pulmonary hypertension (PPH).1 In fact, SLTx for end-stage PPH can get good result of low operative mortality; immediate, complete , and durable amelioration of pulmonary hypertension.1-3 However, critical postoperative care of patients undergoing SLTx for PPH is still a big medical challenge .4 The main difficulty is from the reperfusion edema of the transplanted lung, which can result in a potentially fatal respiratory failure. 5, 6 Cardiopulmonary support is always needed during SLTx for PPH. Conventional cardiopulmonary bypass ( CPB) through the femoral route or intrathoracic route used to be applied for this indication. However, the conventional CPB is not completely benign. There are significant complications of bleeding tendency and early graft dysfunction from its use.7 We reported our experiences of using extracorporeal membrane oxygenation (ECMO) instead of the conventional CPB in SLTx for PPH and extending its use into the early postoperative period. By this method, we prevented major complications of CPB and made easier the early postoperative critical care in patients undergoing SLTx for PPH.