Bridge to Lung Transplant With Trans-septal Extra-corporeal Membrane Oxygenation (ECMO) for Right Heart Failure From Pulmonary Hypertension

Inclusion Criteria

• •Patients that are listed for lung transplantation and have:
• •PH defined as:
• •* Group 1 Pulmonary arterial hypertension (PAH): Mean pulmonary artery pressure (PAP) ≥ 20 mm Hg, pulmonary capillary wedge pressure (PCWP) \< 15 mm Hg, and pulmonary vascular resistance (PVR) ≥ 3 Wood units
• •* Group 3 PH is defined as the presence of chronic lung disease (CLD) and/or hypoxia and mean pulmonary artery pressure (PAP) ≥ 20 mm Hg.
• •Secondary PH (WHO Group 3) or diagnosis of primary PH (WHO Group 1) (to include Eisenmenger syndrome).
• •Failing right ventricle function defined as:
• •* a cardiac (CI) index \< 2.2 L/min/m\^2 despite continuous infusion of high dose inotropes defined as:
• •* Inhaled nitric oxide \> 20 ppm and one of the following:
• •* Dobutamine \> 10 ug/kg/min x 15 minutes or
• •* Milrinone \> 0.5 ug/kg/min x 120 minutes or
• •* Epinephrine \> 0.5 ug/kg/min x 15 minutes or
• •* Norepinephrine \> 0.5 ug/kg/min x 15 minutes and have one of the following:
• •1. central venous pressure (CVP) \> 15 mm Hg
• •2. global RV dysfunction on echocardiography defined as one of the following:
• •1. a tricuspid annular plane systolic excursion score of \<14mm
• •2. an RV diameter at base \>42mm
• •3. RV short-axis or midcavity diameter \>35mm
• •* Lactate greater than 3 mmol/L
• •* Urine output \< 0.5 ml/kg/hour
• •Age \> 18 years old
• •BMI \<35
• •Informed consent signed by self or legally authorized representative.