Bridge to thoracic organ transplantation in patients with pulmonary arterial hypertension using a pumpless lung assist device

Am J Transplant. 2009 Apr;9(4):853-7. doi: 10.1111/j.1600-6143.2009.02549.x.


We describe a novel technique of pumpless extracorporeal life support in four patients with cardiogenic shock due to end-stage pulmonary hypertension (PH) including patients with veno-occlusive disease (PVOD) using a pumpless lung assist device (LAD). The device was connected via the pulmonary arterial main trunk and the left atrium, thereby creating a septostomy-like shunt with the unique addition of gas exchange abilities in parallel to the lung. Using this approach, all four patients were successfully bridged to bilateral lung transplantation and combined heart-lung transplantation, respectively. Although all patients presented in cardiogenic shock, hemodynamic unloading of the right ventricle using the low-resistance LAD stabilized the hemodynamic situation immediately so that no pump support was subsequently required.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Assisted Circulation / methods*
  • Equipment Design
  • Female
  • Heart Failure / surgery
  • Heart-Assist Devices*
  • Heart-Lung Transplantation / physiology*
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / surgery*
  • Life Support Systems / instrumentation*
  • Lung Transplantation / physiology*
  • Male
  • Treatment Outcome
  • Young Adult