Cadaveric donor lobar lung transplantation for patients on extracorporeal membrane oxygenation as bridge-to-transplant.

The total number of lung transplants reported to the International Society of Heart and Lung Transplantation registry continues to increase steadily. In the US, the lung transplant volume has increased from 1172 in 2004 to 1822 in 2011 since lung allocation score system was implemented in 2005 while the overall 1-year survival after transplantation has not changed significantly. One of the most common reasons why lung offers are declined is size-mismatch. Size-reduced lung transplantation including non-anatomical lung volume reduction and lobar lung transplantation is an advanced surgical technique to alleviate donor organ shortage. Living-related donor lung transplantation almost disappeared in the US, but alternatively, we perform lobar transplantation using cadaveric donor lungs. With recent advances in extracorporeal membrane oxygenation (ECMO) technology and surgical experience, ECMO has been used before, during and after lung transplant surgery successfully.