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First Danish experience with ex vivo lung perfusion of donor lungs before transplantation

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@article{26077c5d589f445dae4078ef54cae85b,
title = "First Danish experience with ex vivo lung perfusion of donor lungs before transplantation",
abstract = "INTRODUCTION: The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction.MATERIAL AND METHODS: The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test.RESULTS: In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively.CONCLUSION: In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs.FUNDING: no funding was granted for the present paper.TRIAL REGISTRATION: not relevant.",
keywords = "Denmark, Donor Selection, Humans, Lung, Lung Transplantation, Perfusion, Preoperative Care, Tissue Donors",
author = "Henriksen, {Ian Sune Iversen} and Hasse M{\o}ller-S{\o}rensen and M{\o}ller, {Christian Holdfold} and Mikhail Zemtsovski and Nilsson, {Jens Christian} and Seidelin, {Casper Tobias} and Michael Perch and Martin Iversen and Daniel Steinbr{\"u}chel",
year = "2014",
month = mar,
language = "English",
volume = "61",
pages = "A4809",
journal = "Danish Medical Bulletin (Online)",
issn = "1603-9629",
publisher = "Almindelige Danske Laegeforening",
number = "3",

}

RIS

TY - JOUR

T1 - First Danish experience with ex vivo lung perfusion of donor lungs before transplantation

AU - Henriksen, Ian Sune Iversen

AU - Møller-Sørensen, Hasse

AU - Møller, Christian Holdfold

AU - Zemtsovski, Mikhail

AU - Nilsson, Jens Christian

AU - Seidelin, Casper Tobias

AU - Perch, Michael

AU - Iversen, Martin

AU - Steinbrüchel, Daniel

PY - 2014/3

Y1 - 2014/3

N2 - INTRODUCTION: The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction.MATERIAL AND METHODS: The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test.RESULTS: In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively.CONCLUSION: In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs.FUNDING: no funding was granted for the present paper.TRIAL REGISTRATION: not relevant.

AB - INTRODUCTION: The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction.MATERIAL AND METHODS: The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test.RESULTS: In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively.CONCLUSION: In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs.FUNDING: no funding was granted for the present paper.TRIAL REGISTRATION: not relevant.

KW - Denmark

KW - Donor Selection

KW - Humans

KW - Lung

KW - Lung Transplantation

KW - Perfusion

KW - Preoperative Care

KW - Tissue Donors

M3 - Journal article

C2 - 24814919

VL - 61

SP - A4809

JO - Danish Medical Bulletin (Online)

JF - Danish Medical Bulletin (Online)

SN - 1603-9629

IS - 3

ER -

ID: 45027323