Ex Vivo Lung Perfusion: Early Report of Brazilian Experience

Pêgo-Fernandes, Paulo Manuel; Medeiros, Israel Lopes de; Mariani, Alessandro Wasum; Fernandes, Flávio Guimarães; Unterpertinger, Fernando do Valle; Samano, Marcos Naoyuki; Werebe, Eduardo de Campos; Canzian, Mauro; Jatene, Fábio Biscegli

doi:10.1016/j.transproceed.2010.01.015

Cited by 30 publications

(22 citation statements)

References 9 publications

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“…Other clinical studies of EVLP have demonstrated similar results. [8,[11][12][13][14] In our study, we evaluated biochemical patterns of unallocated lungs undergoing EVLP. In selecting biomarkers for evaluation, we chose several biochemicals of known importance to LTx.…”

Section: Discussionmentioning

confidence: 99%

292 Physiologic and Biochemical Profile of Clinically Rejected Lungs on a Normothermic Ex Vivo Lung Perfusion Platform

George

Arnaoutakis

Beaty

et al. 2012

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 99%

292 Physiologic and Biochemical Profile of Clinically Rejected Lungs on a Normothermic Ex Vivo Lung Perfusion Platform

George

Arnaoutakis

Beaty

et al. 2012

The Journal of Heart and Lung Transplantation

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“…The system used during the reperfusion phase consisted of the XVIVO box (VitroLife AB, Gothenburg, Sweden), attached to the centrifugal pump, heat exchanger, membrane oxygenator and a venous reservoir (Braile Biomedica, São José do Rio Preto, Brazil), as we previously described. 11 The Y cannula for the pulmonary arteries had two separate probes connected to pressure transducers that allowed continuous and independent monitoring of pulmonary artery pressure. The right and left lung pulmonary vein effluents were collected directly into the XVIVO box, where they were mixed and drained into the venous reservoir by gravity.…”

Section: Methodsmentioning

confidence: 99%

Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study

et al. 2014

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CONTEXT AND OBJECTIVE: Lung preservation remains a challenging issue for lung transplantation groups. Along with the development of ex vivo lung perfusion, a new preservation method known as topical-ECMO (extracorporal membrane oxygenation) has been proposed. The present study compared topical-ECMO with cold ischemia (CI) for lung preservation in an ex vivo experimental model. DESIGN AND SETTING: Randomized experimental study, conducted at a public medical school. METHOD: Fourteen human lungs were retrieved from seven brain-dead donors that were considered unsuitable for transplantation. The lung bloc was divided and each lung was randomized to be preserved by means of topical-ECMO or CI (4-7 °C) for eight hours. These lungs were then reconnected to an ex vivo perfusion system for functional evaluation. Lung biopsies were obtained at three times. The functional variables assessed were oxygenation capacity (OC) and pulmonary artery pressure (PAP); and the histological variables were lung injury score (LIS) and apoptotic cell count (ACC). RESULTS:The mean OC was 468 mmHg (± 81.6) in the topical-ECMO group and 455.8 (± 54) for CI (P = 0.758). The median PAP was 140 mmHg (120-160) in the topical-ECMO group and 140 mmHg (140-150) for CI (P = 0.285). The mean LIS was 35.57 (± 4.5) in the topical-ECMO group and 33.86 (± 6.1) for CI (P = 0.367). The ACC was 25.00 (± 9.34) in the topical-ECMO group and 24.86 (± 10.374) for CI (P = 0.803). CONCLUSIONS:The present study showed that topical-ECMO was not superior to cold ischemia for up to eight hours of lung preservation. RESUMO CONTEXTO E OBJETIVO:A preservação pulmonar permanece um desafio para os grupos transplantadores. Com o desenvolvimento da perfusão pulmonar ex vivo, foi proposto um novo método de preservação chamado de ECMO-tópico (oxigenação de membrana extracorpórea). O presente estudo compara ECMOtópico com isquemia fria (IF) para preservação pulmonar em um modelo experimental ex vivo. TIPO DE ESTUDO E LOCAL: Estudo experimental randomizado, conduzido em uma faculdade de medicina pública. MÉTODO: Quatorze pulmões humanos foram retirados de sete doadores de morte cerebral considerados não aptos a transplante. O bloco pulmonar foi dividido e cada um foi aleatorizado para preservação por ECMO-tópico ou IF (4-7 °C) durante oito horas. Esses pulmões foram então re-conectados a um sistema de perfusão ex vivo para avaliação funcional. Biópsias pulmonares foram obtidas em três tempos. As variáveis funcionais avaliadas foram: capacidade de oxigenação (CO) e pressão de artéria pulmonar (PAP). As variáveis histológicas estudadas foram escore de lesão pulmonar (ELP) e contagem de células apoptóticas (CCA). RESULTADOS: A média da CO foi de 468 mmHg (± 81.6) no grupo ECMO-tópico e 455.8 (± 54) no grupo IF (P = 0,758); a PAP média foi de 140 mmHg (120-160) para ECMO-tópico e 140 mmHg (140-150) para IF (P = 0,285); o ELP médio foi 35,57 (± 4,5) no ECMO-tópico e 33,86 (± 6,1) no IF (P = 0,367). A CCA foi 25,00 (± 9,34) no grupo ECMO-tópico e 24,86 (± 10,374) no IF (P = 0...

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“…The study group didn't observe any significant differences in terms of primary graft dysfunction (PGD), days on mechanical ventilation after transplant, ICU stay, hospital stay, and 30-day mortality (32). Finally, several groups have used lungs from DCDs after ex vivo assessment with outcomes comparable to using without ex vivo and some of these proclaimed using ex vivo will improve DCD lung selection, and increased the uses of DCD lungs (9,16,(43)(44)(45). The conversion rate from EVLP to transplantation varies between 46 and 87% (15,(30)(31)(32)(37)(38)(39)(40)(41)(42)(43).…”

Section: Assessment During Evlpmentioning

confidence: 99%

Ex vivo lung perfusion review of a revolutionary technology

Makdisi

Jarmi

et al. 2017

Ann. Transl. Med.

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Donor lung shortage has been the main reason to the increasing number of patients waiting for lung transplant. Ex vivo lung perfusion (EVLP) is widely expanding technology to assess and prepare the lungs who are considered marginal for transplantation. The outcomes are encouraging and comparable to the lungs transplanted according to the standard criteria. In this article, we will discuss the history of development, the techniques and protocols of ex vivo, and the logics and rationales for ex vivo use.

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Ex Vivo Lung Perfusion: Early Report of Brazilian Experience

Cited by 30 publications

References 9 publications

292 Physiologic and Biochemical Profile of Clinically Rejected Lungs on a Normothermic Ex Vivo Lung Perfusion Platform

292 Physiologic and Biochemical Profile of Clinically Rejected Lungs on a Normothermic Ex Vivo Lung Perfusion Platform

Cold ischemia or topical-ECMO for lung preservation: a randomized experimental study

Ex vivo lung perfusion review of a revolutionary technology

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