Development of a new interfacility extracorporeal membrane oxygenation transport program for pediatric lung transplantation evaluation

Abstract

Pediatric lung transplantation is a life-saving intervention for children with irreversible endstage lung disease. Access to transplant can be limited by geographic isolation from a center or the presence of comorbidities affecting transplant eligibility. Extracorporeal membrane oxygenation (ECMO)-supported patients are an uncommon but historically high-risk cohort of patients considered for lung transplant. We report the development of a service at our center to provide transport services to our hospital for patients unable to wean from ECMO support at their local institution for the purpose of evaluation for lung transplantation by our program. We developed a process for pre-transport consultation by the lung transplant physician team, standardized hand-off tools and equipment lists, and procedures for transitioning patients to transport ECMO machinery. Four patients have been transported to date including fixed wing (FW) and helicopter transports. All patients were successfully transported with either none or minor complications. Transport of ECMO-supported patients is a feasible method to increase access of patients with irreversible lung injured patients to evaluation for lung transplant.

Single-Center Experience Using the Cardiohelp System for Neonatal and Pediatric Extracorporeal Membrane Oxygenation

“…The priming volume is low at 600 mL. It has been successfully used in pediatric inter- and intrahospital transport with low complication rates (9). However, there are limited published data regarding the use of the Cardiohelp system in young children and neonates as the primary ECMO system.…”