Extracorporeal membrane oxygenation before induction of anesthesia in critically ill thoracic transplant patients

Cardiorespiratory failure just before surgery in critically ill thoracic tr ansplant patients can have catastrophic consequences. We judged the cardior espiratory condition in three of 160 thoracic transplant procedures perform ed in our center too unstable for a safe induction of anesthesia. In these 3 patients, extracorporeal membrane oxygenation support was installed befor e induction of anesthesia to maintain an adequate cardiorespiratory state. This strategy was successful for all 3 patients, and long-term survival was achieved with a good quality of life. Guidelines for indications to follow this strategy are discussed. (C) 2001 by The Society of Thoracic Surgeons.