Use of extracorporeal membrane oxygenation (ECMO) in children receiving hematopoietic cell transplantation (HCT) and immune effector cell therapy is controversial and evidence-based guidelines have not been established.

Remarkable advancements in HCT and immune effector cell therapies have changed expectations around reversibility of organ dysfunction and survival for affected patients.

These are the first international, multidisciplinary consensus-based recommendations on the use of ECMO in this patient population.

This Review provides a clinical decision support tool for pediatric hematologists, oncologists, and critical care physicians during the difficult decision-making process of ECMO candidacy and management.

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