Prolonged Preservation and Evaluation of Human Lungs With Portable Normothermic EVLP

Spratt, John R.; Mattison, Lars M.; Kerns, N.K.; Huddleston, Stephen J.; Meyer, Loreen K.; Loor, Gabriel; Iaizzo, Paul A.

doi:10.1016/j.healun.2018.01.1300

Cited by 3 publications

(4 citation statements)

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“…A pilot study presented by the University of Minnesota group at ISHLT in 2018, showed that prolonged EVLP in human lungs rejected for transplant with autologous whole blood for 24 hours was safe and feasible (22). Ten ECD lungs that were not candidates for the EXPAND trial were tested on the device.…”

Section: Blood Perfusates For Prolonged Preservationmentioning

confidence: 99%

“…This should only be utilized in select scenarios, as the real value of portable EVLP comes in the minimization of cold ischemic injury. The pilot study from Spratt and colleagues also utilized the OCS system in a static manner with reasonable success (22). Mohite and colleagues reported a case using the OCS system in a static manner after cold ischemia with a positive outcome as well (26).…”

Section: Ocs Lung Recovery After Dcd Injury-translational Experiencementioning

confidence: 99%

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Breathing lung transplantation with the Organ Care System (OCS) Lung: lessons learned and future implications

2019

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End stage lung diseaseChronic lung disease is the fourth leading cause of death in the United States and is a major health burden worldwide (1). Lung transplant is a treatment option for patients with cystic fibrosis, chronic obstructive pulmonary disease (COPD), interstitial lung disease, pulmonary hypertension and other chronic lung diseases. There are approximately 4,500 lung transplants performed annually world-wide and the number continues to grow (2). Yet there are significant limitations with transplant. One of the biggest challenges is the critical organ shortage. Patients have a 15-30% chance of dying on the waiting list depending on their diagnosis and urgency (3). Currently, only 20% of organ offers are transplanted. Thus, 80% of lungs are discarded. Another challenge is primary graft dysfunction (PGD) which is described below. Finally, the quality of the organ at the time of transplant can contribute to chronic lung allograft dysfunction (CLAD), which occurs in 50% of patients by five years after transplant. PGDUp to 30% of transplanted lungs will develop PGD. PGD is graded from zero to three, with three being the worst category of graft dysfunction. PGD is associated with a high rate of mortality in the hospital and following discharge (4).An important donor risk factor for development of PGD is cigarette smoking. Other risk factors may include aspiration, chest trauma, lung contusions, undersized donors relative to recipient, and heavy alcohol use (5). Recipient risk factors for PGD include pre-transplant lung diseases other than COPD or cystic fibrosis, obesity and pulmonary hypertension. Importantly, prolonged cold ischemic time is associated with PGD. Ex vivo lung perfusion (EVLP)EVLP describes a concept of perfusing and ventilating a donor lung outside of the donor and recipient. Breathing lung transplantation is a form of EVLP. The Organ Care

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Section: Blood Perfusates For Prolonged Preservationmentioning

confidence: 99%

Section: Ocs Lung Recovery After Dcd Injury-translational Experiencementioning

confidence: 99%

Breathing lung transplantation with the Organ Care System (OCS) Lung: lessons learned and future implications

2019

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“…A commercially available isolated lung perfusion system called the Organ Regenerative Control Acquisition bioreactor (Harvard Apparatus Regenerative Technologies, Holliston, MA, USA) has also been used by others for decellularisation [33,34,136]. Despite the advances made in the last few years with EVLP systems, the maximum amount of time that a healthy lung can be maintained ex vivo and transplanted is in the range of 6 h [137][138][139]. It is thought that bioengineering lungs ex vivo will require a far longer period of maturation time in a bioreactor prior to transplantation.…”

Section: Bioreactor Strategies For Lung Bioengineeringmentioning

confidence: 99%

How to build a lung: latest advances and emerging themes in lung bioengineering

et al. 2018

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Chronic respiratory diseases remain a major cause of morbidity and mortality worldwide. The only option at end-stage disease is lung transplantation, but there are not enough donor lungs to meet clinical demand. Alternative options to increase tissue availability for lung transplantation are urgently required to close the gap on this unmet clinical need. A growing number of tissue engineering approaches are exploring the potential to generate lung tissue for transplantation. Both biologically derived and manufactured scaffolds seeded with cells and grown have been explored in pre-clinical studies, with the eventual goal of generating functional pulmonary tissue for transplantation. Recently, there have been significant efforts to scale-up cell culture methods to generate adequate cell numbers for human-scale bioengineering approaches. Concomitantly, there have been exciting efforts in designing bioreactors that allow for appropriate cell seeding and development of functional lung tissue over time. This review aims to present the current state-of-the-art progress for each of these areas and to discuss promising new ideas within the field of lung bioengineering.

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“…Monitoring bioreactors were utilized to measure biological parameters of the cells within the engineered tissues (e.g., O 2 and CO 2 levels, glucose consumption, lactate production, and pH values), helping control and optimize the culture conditions to manage and determine the maturation time of the bioengineered lungs before transplantation (Engler et al, 2018;Mahfouzi et al, 2018). Ex vivo lung perfusion (EVLP) systems were also applied to recover and maintain lungs ex vivo for transplantation for several hours (Spratt et al, 2017(Spratt et al, , 2018(Spratt et al, , 2020Warnecke et al, 2012). In addition, the application of bioreactors in lung disease modeling was investigated.…”

Section: Introductionmentioning

confidence: 99%

Advances in bioreactors for lung bioengineering: From scalable cell culture to tissue growth monitoring

Mahfouzi

Amoabediny

Tali

2021

Biotech & Bioengineering

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Prolonged Preservation and Evaluation of Human Lungs With Portable Normothermic EVLP

Cited by 3 publications

References 0 publications

Breathing lung transplantation with the Organ Care System (OCS) Lung: lessons learned and future implications

Breathing lung transplantation with the Organ Care System (OCS) Lung: lessons learned and future implications

How to build a lung: latest advances and emerging themes in lung bioengineering

Advances in bioreactors for lung bioengineering: From scalable cell culture to tissue growth monitoring

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