Role of ECMO in Transplant Recipient

Abstract

Extracorporeal life support (ECLS) for heart/lung in a patient in cardiorespiratory failure is a highly specialized technique which needs careful patient selection, resources, infrastructure and interdisciplinary expertise much like a transplant program. The aim of this editorial is to outline the scope of Extracorporeal membrane oxygenator (ECMO) in preoperative bridging and perioperative management of sick patients with organ failure awaiting transplant as well as post-transplant. The attempt is to collate data of international and national experience for reference. ECMO is a validated tool as a bridge to heart or lung transplant if the patients decompensate while awaiting a transplant. The method, timing of initiation and end objectives of ECMO in these patients is not the same as that for conventional patients with sudden onset heart lung failure. Of greater challenge is the role of ECMO in liver transplant recipient perioperatively as it is definitely not a bridge to liver transplant. However, with careful selection and in ideal candidates ECMO can be used to stabilize a patient with liver failure or chronic liver disease who may otherwise be deemed too sick to transplant.