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. 2020 Apr;12(4):1350-1356.
doi: 10.21037/jtd.2020.02.26.

Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection

Achim Koch  1   2 , Nikolaus Pizanis  1   2 , Vasiliki Bessa  1   3 , Alexis Slama  1   4 , Clemens Aigner  1   4 , Christian Taube  1   3 , Markus Kamler  1   2
Affiliations

Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection

Achim Koch et al. J Thorac Dis. 2020 Apr.

Abstract

Background: The low acceptance rates in lung transplantation underline the importance to use every potential transplantable organ. With the use of normothermic ex vivo lung perfusion (EVLP) there is a potential to use more donor lungs for transplantation. Aim of this study was to evaluate if EVLP has an effect on cytomegalovirus (CMV) infection after lung transplantation.

Methods: Between May 2016 and October 2018, 57 lung transplants were performed. Out of these 21 extended criteria lungs were evaluated by EVLP and 16 transplanted. In a retrospective study, results of EVLP treated lungs were compared with lungs after cold storage preservation (CSP). Donor/recipient CMV IgG status and seroconversion rate was examined.

Results: Donors were CMV IgG+ in EVLP 69% and CSP 61% (n.s.). Best pO2 on procurement at FiO2 1.0 was in EVLP 278±76 versus CSP 413±96 mmHg (P≤0.05). Recipients were CMV IgG+ in EVLP 38% and CSP 63% (P<0.07). CMV seroconversion: EVLP 12%, CSP 20% (P<0.05), in the CSP group in 5% recipients with more than 1,000 copies/mL were diagnosed by PCR and treated for CMV infection. Procalcitonin (PCT) levels from day 1 to day 5 were significantly lower for CSP group (P<0.05). 30-day mortality was 12% for EVLP recipients.

Conclusions: Normothermic EVLP did not influence CMV infection rate, however early PCT levels were higher in EVLP group. Short-term results were comparable to standard lung transplantation.

Keywords: Cytomegalovirus infection (CMV infection); ex vivo lung perfusion (EVLP); extended criteria donors (ECD); lung transplantation.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.02.26). The authors have no conflicts of interest to declare.

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