SUCCESSFUL USE OF EXTRACORPOREAL MEMBRANE-OXYGENATION (ECMO) DURING BMT FOR SCID

An 8-month-old girl with SCID presented with severe bronchiolitis. She received an HLA-identical sibling BMT without conditioning or GVHD pr ophylaxis, She deteriorated despite mechanical ventilation but had nor mal cardiac, hepatic and renal function. ECMO was instituted on day +3 and subsequent improvement was seen concurrently with emergence of CD 4(+) cells on day +11, She was taken off ECMO on day +18 and suffered a left-sided stroke evidenced by a dense left hemiplegia. She was extu bated on day +25 and weaned from supplemental oxygen on day +36 and at day +100 has recovered strength in her extremities. This is the first successful use of ECMO as a bridge to engraftment in a BMT patient.