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Multicenter Study
. 2019 Apr 1;55(4):766-772.
doi: 10.1093/ejcts/ezy354.

Lung transplantation after ex vivo lung perfusion in two Scandinavian centres

Tobias Nilsson  1 , Andreas Wallinder  2 , Ian Henriksen  3 , Jens Christian Nilsson  3 , Sven-Erik Ricksten  1 , Hasse Møller-Sørensen  3 , Gerdt C Riise  4   5 , Michael Perch  6   7 , Göran Dellgren  2   4
Affiliations
Multicenter Study

Lung transplantation after ex vivo lung perfusion in two Scandinavian centres

Tobias Nilsson et al. Eur J Cardiothorac Surg. .

Abstract

Objectives: We reviewed our combined clinical outcome in patients who underwent lung transplantation after ex vivo lung perfusion (EVLP) and compared it to the contemporary control group.

Methods: At 2 Scandinavian centres, lungs from brain-dead donors, not accepted for donation but with potential for improvement, were subjected to EVLP (n = 61) and were transplanted if predefined criteria were met. Transplantation outcome was compared with that of the contemporary control group consisting of patients (n = 271) who were transplanted with conventional donor lungs.

Results: Fifty-four recipients from the regular waiting list underwent transplantation with lungs subjected to EVLP (1 bilateral lobar, 7 single and 46 double). In the EVLP and control groups, arterial oxygen tension/inspired oxygen fraction ratio at arrival in the intensive care unit (ICU) was 30 ± 14 kPa compared to 36 ± 14 (P = 0.005); median time to extubation was 18 h (range 2-912) compared to 7 (range 0-2280) (P = 0.002); median ICU length of stay was 4 days (range 2-65) compared to 3 days (range 1-156) (P = 0.002); Percentage of expected forced expiratory volume at 1s (FEV1.0%) at 1 year was 75 ± 29 compared to 81 ± 26 (P = 0.18); and the 1-year survival rate was 87% [confidence interval (CI) 82-92%] compared to 83% (CI 81-85), respectively. Follow-up to a maximum of 5 years did not show any significant difference in survival between groups (log rank, P = 0.63).

Conclusions: Patients transplanted with lungs after EVLP showed outcomes comparable to patients who received conventional organs at medium-term follow-up. Although early outcome immediately after transplantation showed worse lung function in the EVLP group, no differences were observed at a later stage, and we consider EVLP to be a safe method for increasing the number of transplantable organs.

Keywords: Ex vivo lung perfusion; Lung reconditioning; Lung transplantation.

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Figures

Figure 1:
Figure 1:
All donor lungs offered to our 2 centres during the study period. Bilateral: bilateral sequential lung transplantation; EVLP: ex vivo lung perfusion; Single: single lung transplantation; Tx: transplantation.
Figure 2:
Figure 2:
Survival and freedom from retransplantation after lung transplantation. The combined EVLP and control groups had a similar survival and freedom from retransplantation after transplantation. EVLP: ex vivo lung perfusion.
None
See this image and copyright information in PMC

References

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