ABSTRACT
Lung transplantation is an established therapy for end-stage lung disease. Following implementation of the lung allocation score in 2005, the use of mechanical ventilation, extracorporeal membrane oxygenation (ECMO), or both as a bridge to transplantation increased. Mechanical ventilation and ECMO have successfully bridged selected patients to transplantation but are associated with higher resource use and mortality. Refinements in patient selection, ECMO circuits, and perioperative care now permit ECMO support in awake and sometimes ambulatory patients before transplantation. Bridging patients to transplantation with mechanical ventilation or ECMO is increasingly common, and in properly selected patients, it may be the only lifesaving option for critically ill patients awaiting a donor lung.
