Pregnant women with influenza-A have an increased risk of developing acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) can be used as salvage therapy, with lung transplantation as a therapeutic option. However, successful bilateral lung transplantation during pregnancy has never been reported before. We herein report the case of a 34-year-old primipara, who was diagnosed with ARDS caused by influenza-A-induced pneumonia at early gestation. After considering all possible therapeutic options and being fully dependent on VV-ECMO support, she underwent bilateral lung transplantation. The transplantation with intraoperative central VA-ECMO support was successfully performed with good recovery after an initial primary graft dysfunction. The pregnancy was prolonged until 29⁺⁵ gestational weeks. The newborn exhibited growth retardation and was initially stabilized, but later died due to severe, hypoxic respiratory failure and pulmonary hypertension. In conclusion, lung transplantation is a possible salvage therapy for patients with severe lung failure following ARDS during pregnancy. However, it places the mother and unborn child at risk. A multi-professional approach is warranted to diagnose and treat complications at an early stage.

中文翻译：

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ECMO治疗甲型流感致ARDS后孕期双侧肺移植

患有甲型流感的孕妇患急性呼吸窘迫综合征 (ARDS) 的风险增加。体外膜肺氧合 (ECMO) 可用作挽救疗法，肺移植可作为一种治疗选择。然而，妊娠期间成功的双侧肺移植以前从未有过报道。我们在此报告一例 34 岁的初产妇，她在妊娠早期被诊断患有由甲型流感引起的肺炎引起的 ARDS。在考虑了所有可能的治疗方案并完全依赖 VV-ECMO 支持后，她接受了双侧肺移植。在最初的原发性移植物功能障碍后，成功进行了术中中央 VA-ECMO 支持的移植，恢复良好。妊娠期延长至29 ⁺⁵ 妊娠周。新生儿表现出生长迟缓，最初情况稳定，但后来因严重缺氧性呼吸衰竭和肺动脉高压而死亡。总之，肺移植是妊娠期 ARDS 后严重肺衰竭患者的一种可能的挽救治疗。然而，它使母亲和未出生的孩子处于危险之中。需要多专业的方法来早期诊断和治疗并发症。