Impact of Ex Vivo Lung Perfusion on Brain‐Dead Donor Lung Utilization: the French Experience

Author(s):  
Naïssa Abdoul ◽  
Camille Legeai ◽  
Christelle Cantrelle ◽  
Olaf Mercier ◽  
Anne Olland ◽  
...  
Author(s):  
S. V. Gautier ◽  
O. M. Tsirulnikova ◽  
I. V. Pashkov ◽  
N. V. Grudinin ◽  
D. O. Oleshkevich ◽  
...  

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.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Triin Major ◽  
Alexandra L. Ball ◽  
John P. Stone ◽  
Rebecca J. Edge ◽  
Gloria Lopez-Castejon ◽  
...  

2016 ◽  
Vol 35 (4) ◽  
pp. S305
Author(s):  
J.R. Spratt ◽  
L.M. Mattison ◽  
P.A. Iaizzo ◽  
T. Iles ◽  
W.D. Payne ◽  
...  

2020 ◽  
Vol 55 (4) ◽  
pp. 1902222 ◽  
Author(s):  
Aaron Wong ◽  
Ricardo Zamel ◽  
Jonathan Yeung ◽  
Gary D. Bader ◽  
Claudia C. Dos Santos ◽  
...  

IntroductionThe ex vivo lung perfusion (EVLP) technique has been developed to assess the function of marginal donor lungs and has significantly increased donor lung utilisation. EVLP has also been explored as a platform for donor lung repair through injury-specific treatments such as antibiotics or fibrinolytics. We hypothesised that actively expressed pathways shared between transplantation and EVLP may reveal common mechanisms of injury and potential therapeutic targets for lung repair prior to transplantation.Materials and methodsRetrospective transcriptomics analyses were performed with peripheral tissue biopsies from “donation after brain death” lungs, with 46 pre-/post-transplant pairs and 49 pre-/post-EVLP pairs. Pathway analysis was used to identify and compare the responses of donor lungs to transplantation and to EVLP.Results22 pathways were enriched predominantly in transplantation, including upregulation of lymphocyte activation and cell death and downregulation of metabolism. Eight pathways were enriched predominantly in EVLP, including downregulation of leukocyte functions and upregulation of vascular processes. 27 pathways were commonly enriched, including activation of innate inflammation, cell death, heat stress and downregulation of metabolism and protein synthesis. Of the inflammatory clusters, Toll-like receptor/innate immune signal transduction adaptor signalling had the greatest number of nodes and was central to inflammation. These mechanisms have been previously speculated as major mechanisms of acute lung injury in animal models.ConclusionEVLP and transplantation share common molecular features of injury including innate inflammation and cell death. Blocking these pathways during EVLP may allow for lung repair prior to transplantation.


2015 ◽  
Vol 34 (4) ◽  
pp. S39-S40 ◽  
Author(s):  
J.C. Yeung ◽  
R. Zamel ◽  
X. Bai ◽  
T.N. Machuca ◽  
M. Liu ◽  
...  

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