Ex vivo lung perfusion in Brazil

Objective: To evaluate the use of ex vivo lung perfusion (EVLP) clinically to prepare donor lungs for transplantation. Methods: A prospective study involving EVLP for the reconditioning of extended-criteria donor lungs, the criteria for which include aspects such as a PaO2/FiO2 ratio < 300 mmHg. Between February of 2013 and February of 2014, the lungs of five donors were submitted to EVLP for up to 4 h each. During EVLP, respiratory mechanics were continuously evaluated. Once every hour during the procedure, samples of the perfusate were collected and the function of the lungs was evaluated. Results: The mean PaO2 of the recovered lungs was 262.9 ± 119.7 mmHg at baseline, compared with 357.0 ± 108.5 mmHg after 3 h of EVLP. The mean oxygenation capacity of the lungs improved slightly over the first 3 h of EVLP-246.1 ± 35.1, 257.9 ± 48.9, and 288.8 ± 120.5 mmHg after 1, 2, and 3 h, respectively-without significant differences among the time points (p = 0.508). The mean static compliance was 63.0 ± 18.7 mmHg, 75.6 ± 25.4 mmHg, and 70.4 ± 28.0 mmHg after 1, 2, and 3 h, respectively, with a significant improvement from hour 1 to hour 2 (p = 0.029) but not from hour 2 to hour 3 (p = 0.059). Pulmonary vascular resistance remained stable during EVLP, with no differences among time points (p = 0.284). Conclusions: Although the lungs evaluated remained under physiological conditions, the EVLP protocol did not effectively improve lung function, thus precluding transplantation.

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236: Removing Interleukin-8 by Adsorbent Membrane Does Not Improve Lung Function during Prolonged Ex-Vivo Lung Perfusion

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2008.11.866 ◽

2009 ◽

Vol 28 (2) ◽

pp. S148-S149

Author(s):

T. Kakishita ◽

T. Oto ◽

S. Otani ◽

S. Yamamoto ◽

O. Yoshida ◽

...

Keyword(s):

Lung Function ◽

Ex Vivo ◽

Lung Perfusion ◽

Interleukin 8 ◽

Improve Lung Function ◽

Ex Vivo Lung Perfusion

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Reliability of Donor Lung Sampling in Lung Transplantation

University of Toronto Journal of Public Health ◽

10.33137/utjph.v2i2.36828 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Bonnie T Chao ◽

Andrew T Sage ◽

Marcelo Cypel ◽

Mingyao Liu ◽

Jonathan Yeung ◽

...

Keyword(s):

Ex Vivo ◽

Lung Perfusion ◽

High Signal ◽

Ex Vivo Lung Perfusion ◽

The Third ◽

Equal Variance ◽

Donor Lung ◽

The Mean ◽

Focal Injury ◽

Signal Variability

Introduction: Ex vivo lung perfusion (EVLP) is a normothermic platform used to assess donor lungs. Many have studied biomarkers in lung injury, but it is unclear whether samples taken from one location are representative of the organ. Our objective was to investigate the uniformity of cytokine expression in tissue biopsies and in EVLP perfusates from various locations. Methods: In the tissue study, eight donor lungs were partitioned from apex to base. In each lung, three biopsies were taken from the third, sixth, and ninth slices, while two were taken from the lingula and an injury site. In the perfusate study, four samples were taken from four lobes in eight donors during EVLP. Expressions of IL-6, IL-8, IL-10, and IL-1β were measured using qPCR and ELISA. Results: In the tissue study, the mean intra-biopsy equal-variance F-value was 0.53. The median intra-biopsy coefficient of variation (CV) was 18%. In donors without gross focal injury, the mean comparisons of biopsies in each donor showed that the three consistent slices showed no differences and had a CV of 20%, which was similar to the intra-biopsy CV (p=0.80). Both the lingula and injury biopsies demonstrated larger differences from the rest. The median intra-lung CV of perfusates from different lobes was 4.9%. Conclusion: Intra-biopsy variances were consistent across biopsies. Lungs without gross focal injury demonstrated more consistent gene expression. The lingula is not a representative site due to high signal variability. The consistent measurements in EVLP perfusates provided a uniform picture of the inflammation.

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