Strueber M, Hoeper MM, Fischer S et al.
Hannover Medical School, Hannover, Germany.
Am J Transplant 2009;9:853–7.
Editor’s note: For many patients with end-stage pulmonary arterial hypertension, the only life-saving option is transplantation. However, the availability of suitable donor organs is limited and, as a result, conditions may worsen while patients are still on transplantation waiting lists. Deterioration can sometimes be rapid, for example in the case of pulmonary veno-occlusive disease (PVOD), necessitating the use of extracorporeal circulatory support as a bridge to transplantation. A pump-driven extracorporeal membrane oxygenation (ECMO) machine is normally used in this setting; however, run time is restricted to approximately 2 weeks, as use beyond this point significantly increases the risk of serious complications such as hemolysis, bleeding at surgical or cannulation sites, sepsis, multiorgan failure, and cerebrovascular events. This brief communication documents the initial experience with a pumpless lung-assist device (LAD) used in a novel pulmonary artery (PA)-to-left atrium (LA) configuration in pulmonary hypertension (PH) patients with cardiogenic shock.