Extracorporeal Life Support (ECLS) Lab

The Extracorporeal Life Support (ECLS) Lab is advancing life support and organ transplantation technologies.

Current Research in the Extracorporeal Life Support Lab

With decades of leadership at the forefront of life support and artificial organ research and technology development, the Extracorporeal Life Support (ECLS) Laboratory, led by Alvaro Rojas-Pena, M.D., works to save patients suffering from acute cardiac, respiratory and other organ failure and improve quality of life. Research efforts in our laboratory build upon extracorporeal life support (ECLS) technology, including extracorporeal membrane oxygenation, or ECMO, developed nearly 50 years ago by Professor Emeritus Robert H. Bartlett, M.D. Dr. Bartlett continues to direct the ECLS laboratory as it investigates new patient populations and clinical applications. 

Work on ECLS has been funded by the National Institutes of Health continuously since 1971. Today, laboratory funding from all sources amounts to approximately $2 million per year. Funds support a wide range of high-impact and innovative research initiatives – initiatives that are changing how we think about life support and organ transplantation and how we care for our patients in greatest peril. Examples of ECLS research projects include development of an implantable artificial lung, an artificial placenta for extremely premature infants, an artificial kidney system to treat systemic infection and systems to resuscitate, maintain and heal donor organs to expand the supply available for transplantation. With 14 principal investigators and extensive collaborations throughout the U-M Medical School and College of Engineering, the ECLS Research Laboratory also provides extraordinary research opportunities  for undergraduates, recent graduates, medical students and medical resident research fellows. 

The Problems

The ECLS Laboratory continually pushes the envelope and broadens the scope of problems we investigate so we can ultimately improve outcomes and offer better alternatives to our patients.

Some of the longstanding and complex clinical problems we're addressing include: 

  • Reducing complications, including the formation of blood clots, that can arise from cardiopulmonary bypass. Some 100,000 patients annually suffer neurologic, renal, hepatic, cardiac and respiratory complications following placement on a heart-lung machine during surgery. 
  • Improving survival and minimizing complications of cardiac arrest. In the United States alone, about 400,000 events of out-of-hospital cardiac arrest take place each year, with fewer than 10% surviving. Those who do have a high likelihood of neurologic and other life-altering complications.
  • Improving outcomes for extremely premature infants, that is, fewer than 28 weeks gestation. At this time, the lungs are still developing and conventional care – mechanical ventilation – is not feasible. Each year, between 30,000 and 40,000 extremely premature infants are born, and few centers in the world are equipped to support them. 
  • Developing and expanding techniques for how we resuscitate, preserve and heal donor organs, including limbs, to improve viability and expand the pool of organs for transplant. Wait times for donor organs are long and, all too often, the condition of organs due to disease or time away from the donor make them unsuitable for transplant. This in turn further reduces supply. As a result, many patients succumb to organ failure before a donor organ can be found.
  • Developing bio-artificial organs, including wearable and implantable artificial lungs, to serve as a bridge to lung transplant or destination therapy in their own right. Many patients with respiratory failure are too sick to undergo transplant. An external artificial lung can minimize symptoms by removing carbon dioxide from the air they breathe and offer an alternative to transplant, much like ventricular assistive devices offer an alternative to many patients with heart failure.

Our early extracorporeal life support work began with neonates, but the technologies and techniques developed in the ECLS Research Laboratory have been expanded to pediatric and adult clinical trials and intensive care. An aging population and discovery of new diseases continue to demand novel ways to support critically ill patients of all ages and improve the quality of their lives.

The Approach

Research in our laboratory focuses on applying ECLS technology to range of clinical problems and requires a deep understanding of the physiology of many processes and pathways. As examples, our cardiac arrest work explores the relationship between blood clot formation and inflammation. This has led us to look at the potentially beneficial role of neutrophil extracellular traps and novel nitric-oxide-eluting device components.

Our work on an artificial placenta aims to replicate the normal physiological gas exchange processes taking place in utero so the fetus' developing lungs can continue to mature without the complications of mechanical ventilation. Our work to preserve donor organs outside the body investigates many pathways of organ injury that result from current preservation methods, including hemoperfusion and inflammation.

Contributions to Science

The ECLS Laboratory has made several significant contributions to science. The following are only a few examples:

  • Our lab's demonstration of and ability to prolong the function of organs ex-vivo for more than 24 hours is an important step toward our vision of building an organ bank to minimize the long and life-threatening wait for a transplant.
  • Similarly, we have developed a device that will soon support extremely premature neonates, offering a viable treatment option when mechanical ventilation cannot be used due to the underdevelopment of the lungs in such young patients.
  • As a result of our work on life support in out-of-hospital cardiac arrest, we are training paramedics and emergency medicine physicians to assess patients for the potential use of extracorporeal cardiopulmonary resuscitation to lessen long-term complications and improve outcomes.
  • We've also led the development and use of nitric-oxide impregnated catheters, which offer both anti-clotting and antibacterial benefits to patients, thereby saving lives as well as billions of dollars annually in costs related to thromboembolism and infection.
  • We're developing new ways and devices to perform fetal surgical interventions to minimize complications, including scarring of the uterus.
  • Research our investigators conducted on how to recover blood vessels for cardiac bypass surgery led to the development of device-agnostic guidelines and standardized techniques for effective endoscopic harvesting. The work has led to improved patient safety and outcomes during these common procedures.

Learn about the $20 million gift to establish the Frankel Innovation Initiative at Michigan Medicine.