A 51-year-old man with dermatomyositis and severe interstitial pulmonary disease was planed for bilateral sequential lung transplantation under general anesthesia. He was supported by extracorporeal membrane oxygenation (ECMO) because of respiratory failure in the preoperative period. ECMO was used during induction and maintenance of anesthesia. After the reperfusion, ECMO was successfully weaned. Postoperatively, the patient was transferred to intensive care unit and discharged without serious complications.