The number of lung transplant procedures performed internationally is increasing but the donor organ pool is insufficient to meet demand and waiting list mortality is unacceptably high. As survival rates for patients with acute respiratory distress syndrome managed on extracorporeal life support (ECLS) have steadily improved, a potential role for ECLS to support critically ill patients awaiting a donor organ match has emerged. We explore the rapidly evolving landscape of ECLS as a bridge to lung transplantation with review of the patient selection criteria, predictors of survival, modes of pre and peri-transplant support, and the importance of a holistic multidisciplinary approach to care. Finally, we consider innovations that are envisaged to increase the accessibility, safety, and effectiveness of ECLS delivery for future lung transplant candidates.

国际上进行的肺移植手术数量正在增加，但供体器官库不足以满足需求，等待名单上的死亡率高得令人无法接受。随着通过体外生命支持 (ECLS) 管理的急性呼吸窘迫综合征患者的生存率稳步提高，ECLS 在支持等待供体器官匹配的危重患者方面的潜在作用已经出现。我们探索 ECLS 快速发展的格局，作为通往肺移植，审查患者选择标准、生存预测因素、移植前和移植期间支持的模式以及整体多学科护理方法的重要性。最后，我们考虑了旨在为未来肺移植候选者增加 ECLS 交付的可及性、安全性和有效性的创新。