Ex Vivo Lung Perfusion: Past, Present, and Future

D’Cunha, Hannah; Rojas, Mauricio

doi:10.1097/mat.0000000000000650

Cited by 11 publications

(4 citation statements)

References 16 publications

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“…In the last two decades, ex vivo lung perfusion (EVLP) has emerged as a new technology with the potential to recondition human donor lungs that would otherwise fall below the acceptable threshold for transplant (16). Provided the need to expand the donor lung pool, the transplant community explored the use of EVLP as a preservation technique for suboptimal donor lungs.…”

Section: Trends In Organ Preservation Techniquesmentioning

confidence: 99%

Current trends in candidate selection, contraindications, and indications for lung transplantation

Arjuna¹,

Olson²,

Walia³

2021

J Thorac Dis

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Lung transplant has been established as the treatment of choice for patients with various forms of end-stage lung disease, in whom non-transplant therapeutic options have failed. Many advances in the realms of basic science, clinical research, surgical technique, and perioperative management have emerged over the past few decades; these innovations have contributed to substantial improvements in survival and quality of life for transplant recipients. However, the field of lung transplantation faces appreciable challenges, including expanding the lung donor pool and ameliorating posttransplant complications, such as primary graft dysfunction, cellular-and antibodymediated rejection, chronic lung allograft dysfunction, and infection (1). One of the most important questions

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Section: Trends In Organ Preservation Techniquesmentioning

confidence: 99%

Current trends in candidate selection, contraindications, and indications for lung transplantation

Arjuna¹,

Olson²,

Walia³

2021

J Thorac Dis

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“…5,[7][8][9] In the LTx context, Ex Vivo Lung Perfusion (EVLP) emerged as a revolutionary technique to preserve, recondition, and eventually treat lung grafts before implantation, ultimately increasing the pool of donors. [10][11][12] As different EVLP procedures have been proposed, the Toronto protocol proved to be particularly efficient and widely adopted. It is based on acellular solution perfusion (Steen solution) keeping the left atrium closed after a period of cold ischemic storage.…”

Section: Introductionmentioning

confidence: 99%

Is there life on the airway tree? A pilot study of bronchial cell vitality and tissue morphology in the ex vivo lung perfusion (EVLP) era of lung transplantation

et al. 2022

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Background: Ex vivo lung perfusion (EVLP) is a relevant procedure to increase the lung donor pool but could potentially increase the airway tree ischemic injury risk.Methods: This study aimed to evaluate the direct effect of EVLP on the airway tree by evaluating bronchial cell vitality and tissue signs of injury on a series of 117 bronchial rings collected from 40 conventional and 19 EVLP-treated lung grafts. Bronchial rings and related scraped bronchial epithelial cells were collected before the EVLP procedure and surgical anastomosis. Results:The preimplantation interval was significantly increased in the EVLP graft group (p < 0.01). Conventional grafts presented cell viability percentages of 47.07 ± 23.41 and 49.65 ± 21.25 in the first and second grafts which did not differ significantly from the EVLP group (first graft 50.54 ± 25.83 and second graft 50.22 ± 20.90 cell viability percentage). No significant differences in terms of histopathological features (edema, inflammatory infiltrate, and mucosa ulceration) were observed comparing conventional and EVLP samples. A comparison of bronchial cell viability and histopathology of EVLP samples retrieved at different time intervals revealed no significant differences. Accordingly, major bronchial complications after lung transplant were not observed in both groups.Conclusions: Based on these data, we observed that EVLP did not significantly impact bronchial cell vitality and airway tissue preservation nor interfere with bronchial anastomosis healing, further supporting it as a safe and useful procedure.

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“…However, donor availability and donor organ quality continue to be critical challenges to lung transplantation. More than 80% of donor lungs are potentially injured or infected and are considered unsuitable for transplantation 2 . Significant improvements in patient outcomes have been made related to changes in donor selection, organ preservation, perioperative management, and better treatment of postoperative complications 3 .…”

Section: Introductionmentioning

confidence: 99%

“…More than 80% of donor lungs are potentially injured or infected and are considered unsuitable for transplantation. 2 Significant improvements in patient outcomes have been made related to changes in donor selection, organ preservation, perioperative management, and better treatment of postoperative complications. 3 Ex vivo lung perfusion (EVLP) is a significant advancement in donor lung preservation that can expand the number of lungs available for transplantation and decrease the waiting time for recipients.…”

Section: Introductionmentioning

confidence: 99%

Decreasing blood wastage during ex vivo lung perfusion recovery through utilization of thermal control technology

Johnson

Bucio

Salerno

et al. 2022

Journal of Cardiac Surgery

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Background The Organ Care System (OCS) is a revolutionary ex vivo organ perfusion technology that can potentially expand the organ retrieval range. The OCS Lung device uses packed red blood cells (pRBC) with a proprietary solution. We report the ability to reduce blood waste during this procedure by using a thermal packaging solution in conjunction with the OCS platform. Methods We retrospectively reviewed all OCS Lung recoveries performed by our recovery team, using pRBCfrom May 2019 to January 2021. Initially, units were stored using passive refrigeration with the Performance cooler at a temperature range of 1–6°C for 4 h. Subsequently, thermal control technology with the ProMed cooler was utilized to maintain the same temperature range for 72 h. Results Twenty‐three recoveries were initiated with 63 pRBC. The Performance cooler was used for 8, while the ProMed cooler for 13. 37.5% of pRBC transported with the Performance cooler was used within the validated time range, while 25.0% were used beyond the validated time range based on clinical judgment. In addition, 37.5% of pRBC transported with the Performance cooler were returned to the institution after canceled recoveries with an estimated loss of $1800; the ProMed cooler had no wastage. Conclusions This study showed that using an advanced thermal packaging solution facilitates proper storage of pRBC and represents an advancement for extended donor lung preservation. The elimination of blood wastage in this initial study portends ongoing benefits for the limited blood supply and reduced cost.

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Ex Vivo Lung Perfusion: Past, Present, and Future

Cited by 11 publications

References 16 publications

Current trends in candidate selection, contraindications, and indications for lung transplantation

Current trends in candidate selection, contraindications, and indications for lung transplantation

Is there life on the airway tree? A pilot study of bronchial cell vitality and tissue morphology in the ex vivo lung perfusion (EVLP) era of lung transplantation

Decreasing blood wastage during ex vivo lung perfusion recovery through utilization of thermal control technology

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