Evidence of Air Trapping During Ex Vivo Lung Perfusion: A Swine Experimental Lung Imaging and Mechanics Study

Santini, Alessandro; Fumagalli, Jacopo; Merrino, Alessandra; Protti, I.; Paleari, M.C.; Montoli, M.; Dondossola, Daniele; Gori, F.; Righi, I.; Rosso, Lorenzo; Gatti, Stefano; Pesenti, Antonio; Grasselli, Giacomo; Zanella, Alberto

doi:10.1016/j.transproceed.2020.10.016

Cited by 6 publications

(1 citation statement)

References 33 publications

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“…As a result, central airway pressures are evenly distributed to the alveoli, therefore increasing the risk of VILI during EVLP. 131 Thus, a preset ventilation strategy may not be ideal for all lungs in EVLP settings. In a preliminary study, the Turin group demonstrated the evidence of VILI and suggested the use of "stress index" to personalize ventilation strategy during EVLP.…”

Section: Positive Pressure Ventilationmentioning

confidence: 99%

Technical Advances Targeting Multiday Preservation of Isolated Ex Vivo Lung Perfusion

Iskender

2024

Transplantation

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Indications for ex vivo lung perfusion (EVLP) have evolved from assessment of questionable donor lungs to treatment of some pathologies and the logistics. Yet up to 3 quarters of donor lungs remain discarded across the globe. Multiday preservation of discarded human lungs on EVLP platforms would improve donor lung utilization rates via application of sophisticated treatment modalities, which could eventually result in zero waitlist mortality. The purpose of this article is to summarize advances made on the technical aspects of the protocols in achieving a stable multiday preservation of isolated EVLP. Based on the evidence derived from large animal and/or human studies, the following advances have been considered important in achieving this goal: ability to reposition donor lungs during EVLP; perfusate adsorption/filtration modalities; perfusate enrichment with plasma and/or donor whole blood, nutrients, vitamins, and amino acids; low-flow, pulsatile, and subnormothermic perfusion; positive outflow pressure; injury specific personalized ventilation strategies; and negative pressure ventilation. Combination of some of these advances in an automatized EVLP device capable of managing perfusate biochemistry and ventilation would likely speed up the processes of achieving multiday preservation of isolated EVLP.

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Section: Positive Pressure Ventilationmentioning

confidence: 99%