At the Hospital for Sick Children in Toronto, Canada, the Novalung extracorporeal membrane ventilator, a pumpless device, was successfully used as a bridge to lung transplantation in a paediatric patient.

Objectives: We share our experience with the support of a 15 yr old female, with life threatening pulmonary hypertension secondary to pulmonary veno-occlusive disease. Building on 20 years of experience with ECMO, our team was guided by the expertise of our Lung Transplant Program, pioneers in lung transplantation.

Methods: Case report. Patient and device management are explained for a month of Novalung support.

Results: Following a brief cardiac arrest and interval of ECMO, using a novel trans-thoracic cannulation arrangement, the Novalung was used as an oxygenating pulmonary artery to left atrial (PA-LA) shunt. Bypassing the lungs and offloading the heart, the Novalung provided CO2 removal and oxygenation. Post operative care and monitoring, and transition to lung transplantation are described. The clinical course of the patient including the anticipation of ventilator failure and its exchange in the operating room are reported. Characteristic safety considerations and their management, including actual and potential complications are illustrated.

Conclusion: The Novalung proved to be a successful device as a bridge to transplantation and may become a key component to paediatric pre-lung transplant care given the paucity of organs available. The interprofessional approach enabled this team to achieve a successful outcome and transition this patient from a certain death to bilateral lung transplantation while optimizing nutrition and physiotherapy.