Normothermic Ex Vivo Lung Perfusion in Clinical Lung Transplantation

Yeung, Jonathan C.; Keshavjee, S.

doi:10.1007/s40472-015-0079-0

Cited by 3 publications

(4 citation statements)

References 44 publications

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“…Initially, the Lund protocol was successfully performed with RBC containing perfusate. Subsequently, EVLP has been demonstrated with acellular perfusate as well 8 . Animal studies have also been performed to evaluate the physiological benefits of RBCs given their buffering action, rheology and oxygen-carrying capacity.…”

Section: Discussionmentioning

confidence: 99%

“…The method described by the Toronto EVLP group was followed for initiation of perfusion, target flows, ventilation strategy and recruitment manoeuvre 8 . Briefly, the lungs were initially perfused through the left atrial cannula to remove debris.…”

Section: Methodsmentioning

confidence: 99%

“…This system can potentially increase the time allowed between recovery of lungs and their subsequent implantation 7 . It can also reverse neurogenic pulmonary oedema by drawing fluid away from the interstitium 8 . Universal availability of such an EVLP system and the experience to operate it can increase the lung utilization rate.…”

mentioning

confidence: 99%

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Development of a cost-effective ex vivo lung perfusion system for lung transplantation in India

Puri¹,

Ganesan²,

Kajal³

et al. 2022

Indian J Med Res

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Background & objectives: Standard donor lung preservation with cold flush and storage allows up to six hours between retrieval of lungs from the donor and transplantation in the recipient. Ex vivo lung perfusion (EVLP) systems mimic physiological ventilation and perfusion in the donor lungs with potential for prolonged lung preservation and donor lung reconditioning. In this study, it was aimed to perform EVLP on discarded donor lungs using a locally developed EVLP system. Methods: Equipment that are routinely used for cardiac surgeries were collected and a functional EVLP system was assembled. This system was used on five pairs of lungs retrieved from brain-dead organ donors. The lungs were ventilated and pulmonary circulation was continuously perfused with a solution containing oxygen and nutrients for four hours. The system was tested without red blood cells (RBCs) added to the solution (acellular group; n=3; A1, A2 and A3) and also with RBCs added to the solution (cellular group; n=2; C1 and C2). Results: The EVLP system was successfully used in four (A1, A2, A3 and C2) of the five lung pairs. Mechanical and gas exchange functions of the lungs were preserved in these lung pairs. One lung pair (C1) worsened and developed pulmonary oedema. Histopathological examination of all five lung pairs was satisfactory at the end of the procedure. Major challenges faced were leakage of solution from the system and obstruction to drainage of RBCs containing solution from the lungs. Interpretation & conclusions: The results of the present study suggest that, it is possible to maintain the lungs retrieved for transplantation in a physiological condition using a locally prepared EVLP system and a solution without RBCs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Development of a cost-effective ex vivo lung perfusion system for lung transplantation in India

Puri¹,

Ganesan²,

Kajal³

et al. 2022

Indian J Med Res

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“…Несмотря на развитие технологии и совершенствование протоколов иммуносупрессивной терапии, долгосрочная выживаемость реципиентов легких остается самой низкой среди всех трансплантаций солидных органов [12,15]. Причиной тому является высокая восприимчивость трансплантированных легких к воздействию как внешних, так и внутренних негативных факторов [9]. Это же обстоятельство актуально и для легких потенциального донора на этапе кондиционирования.…”

Section: Discussionunclassified

Evaluation of the efficacy of a novel perfusion solution for normothermic ex vivo lung perfusion compared with Steen solution™ (animal experimental study)

Gautier

Цирульникова

Пашков

et al. 2021

RJTAO

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Respiratory diseases, together with infectious complications and hereditary lung diseases, rank third in international mortality statistics. Today, lung transplantation is a recognized method of treating end-stage lung diseases. However, the number of transplant surgeries performed is not much. This is down to the high requirements on the condition of a potential lung donor and directly on the quality of the donor lung. This has significantly limited the number of optimal donors. Rehabilitation of donor lungs to optimal gas exchange indicators can be achieved and objectively assessed in the course of ex vivo lung perfusion (EVLP). The EVLP procedure is widespread in leading transplantation centers in Europe and North America. It allows to significantly expand the pool of donor lungs, thereby serving a greater number of patients in need of lung transplantation. The possibility of EVLP procedure using publicly available perfusion equipment was demonstrated. The optimized protocol fully demonstrated its reliability and efficiency. The developed perfusion solution had no statistically significant differences in comparison with the Steen SolutionTM, which in the future will serve as an alternative for EVLP procedure.

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Triaging donor lungs based on a microaspiration signature that predicts adverse recipient outcome

Ramendra

Sage

Yeung

et al. 2023

The Journal of Heart and Lung Transplantation

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Normothermic Ex Vivo Lung Perfusion in Clinical Lung Transplantation

Cited by 3 publications

References 44 publications

Development of a cost-effective ex vivo lung perfusion system for lung transplantation in India

Development of a cost-effective ex vivo lung perfusion system for lung transplantation in India

Evaluation of the efficacy of a novel perfusion solution for normothermic ex vivo lung perfusion compared with Steen solution™ (animal experimental study)

Triaging donor lungs based on a microaspiration signature that predicts adverse recipient outcome

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