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Living-donor lung transplantation for patients on extracorporeal membrane oxygenation support: A case series

Year: 2026

Type: article

Abstract: In recent years, use of extracorporeal membrane oxygenation as a bridge to lung transplantation has increased. We retrospectively reviewed six consecutive patients who underwent living-donor lung transplantation under preoperative extracorporeal membrane oxygenation support at our institution between April 2021 and August 2025. The cohort included three males and three females, including one pediatric patient. Underlying diseases comprised radiation-induced lung injury, coronavirus disease 2019–related lung injury, interstitial pneumonia associated with collagen vascular disease, idiopathic pulmonary arterial hypertension, and pulmonary complications after hematopoietic stem cell transplantation. The mean duration of preoperative extracorporeal membrane oxygenation support was 29 days (range, 4–88). Four patients required sedation before transplantation, and only one was able to undergo rehabilitation while on extracorporeal membrane oxygenation support. All patients underwent bilateral lung transplantation, with a mean size-matching ratio of 99.7% (range, 49.7–266%). There was no early death. Three patients died at 31 months, 11 months, and 6 months for non-graft-related reasons (recurrence of malignant disease, renal failure, and liver failure). Long-term outcomes were influenced primarily by postoperative complications involving extrapulmonary organs rather than lung graft failure. Careful patient selection is essential when considering living-donor lung transplantation in patients receiving preoperative extracorporeal membrane oxygenation support.

Source: JTCVS Open

DOI: 10.1016/j.xjon.2026.102059