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Favourable outcome after prolonged veno-venous extracorporeal membrane oxygenation (V-V ECMO) support for Pneumocystis jirovecii pneumonia in a renal transplant recipient
  1. Daniel Kleinloog,
  2. Jacinta Maas,
  3. Jorge Lopez Matta and
  4. Carlos Elzo Kraemer
  1. Intensive Care Medicine, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr Daniel Kleinloog; danielkleinloog{at}


A 27-year-old man, with a history of renal transplantation, presented with acute kidney failure and Pneumocystis jirovecii pneumonia. The patient developed severe acute respiratory failure and required support by veno-venous extracorporeal membrane oxygenation for a total of 59 days. During this period, the patient had extremely low tidal volumes using a lung protective ventilation strategy and intermittent prone positioning was used to optimise oxygenation. There was full recovery of pulmonary and partial recovery of renal function.

  • pneumonia (infectious disease)
  • adult intensive care
  • unwanted effects / adverse reactions

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  • Contributors DK, JM, JLM and CEK were clinical doctors who took care of the patient during the intensive care unit admission; DK in the role of fellow, JM, JLM and CEK as intensivists and as members of the extracorporeal membrane oxygenation team. JM was the coordinating physician and discussed the draft paper with the patient and his mother and obtained informed consent. DK, JM, JLM and CEK were involved in clinical decision-making. DK wrote the first draft of the paper and JM, JLM and CEK were involved in the rewriting of the paper on numerous occasions and have approved the final manuscript. DK performed the submission process.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

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