Transplantation of lungs after ex vivo reconditioning in a patient on semi-elective long-term veno-arterial extracorporeal life support

We present the case of a 41-year old patient suffering from end-stage pulmonary hypertension secondary to veno-occlusive disease who underwent implantation of a veno-arterial extracorporeal membrane oxygenator as a bridge to lung transplantation (LTx) due to significant deterioration of myocardial pump and liver function. After 33 days on support, lungs with extended donor criteria were offered. Owing to the deteriorating clinical condition of the patient, the lungs were assessed using our ex vivo lung perfusion system. After reconditioning of the graft, a bilateral LTx was performed.