INTRODUCTION
The use of extracorporeal life support (ECLS) as a bridge to lung transplantation has increased over the last decade, however its use in re-do lung transplantation is limited due to poor outcomes1,2. Extracorporeal circulation with a single duo-lumen cannula provides the advantage of more comfortable mobilization particularly in patients in which we expect a longer bridge to transplant. The Hemolung Respiratory Assisted System (HRAS) (ALung Technologies, Pittsburgh PA) is a venous-venous extracorporeal carbon dioxide removal (ECCO2R) system that allows for effective removal of carbon dioxide via a small French double lumen catheter2,3.
In this report the decision to bridge our patient with an HRAS was based on primary hypercapnic respiratory failure and anatomical limitations due to her complete situs inversus.