scholarly journals Current Status and Future Perspectives on Machine Perfusion: A Treatment Platform to Restore and Regenerate Injured Lungs Using Cell and Cytokine Adsorption Therapy

Cells ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 91
Author(s):  
Anna Niroomand ◽  
Gabriel Hirdman ◽  
Franziska Olm ◽  
Sandra Lindstedt
Keyword(s):  
Therapeutic Intervention ◽  
Lung Transplant ◽  
Ex Vivo ◽  
Current Status ◽  
Donor Organ ◽  
Ex Vivo Lung Perfusion ◽  
Cell Therapies ◽  
Donor Lung ◽  
End Stage

Since its advent in the 1990′s, ex vivo lung perfusion (EVLP) has been studied and implemented as a tool to evaluate the quality of a donor organ prior to transplantation. It provides an invaluable window of opportunity for therapeutic intervention to render marginal lungs viable for transplantation. This ultimately aligns with the need of the lung transplant field to increase the number of available donor organs given critical shortages. As transplantation is the only option for patients with end-stage lung disease, advancements in technology are needed to decrease wait-list time and mortality. This review summarizes the results from the application of EVLP as a therapeutic intervention and focuses on the use of the platform with regard to cell therapies, cell product therapies, and cytokine filtration among other technologies. This review will summarize both the clinical and translational science being conducted in these aspects and will highlight the opportunities for EVLP to be developed as a powerful tool to increase the donor lung supply.

scholarly journals Evaluation of the efficacy of a novel perfusion solution for normothermic ex vivo lung perfusion compared with Steen solution™ (animal experimental study)

2021 ◽  
Vol 23 (3) ◽  
pp. 82-89
Author(s):  
S. V. Gautier ◽  
O. M. Tsirulnikova ◽  
I. V. Pashkov ◽  
N. V. Grudinin ◽  
D. O. Oleshkevich ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Lung Diseases ◽  
Ex Vivo ◽  
Infectious Complications ◽  
Lung Perfusion ◽  
Ex Vivo Lung Perfusion ◽  
Perfusion Solution ◽  
Number Of Patients ◽  
Donor Lung ◽  
End Stage

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.

scholarly journals Ex Vivo Lung Perfusion: A Platform for Donor Lung Assessment, Treatment and Recovery

2021 ◽  
Vol 2 (4) ◽  
pp. 387-395
Author(s):  
Luke Milross ◽  
Chelsea Griffiths ◽  
Andrew J. Fisher
Keyword(s):  
Ex Vivo ◽  
Objective Assessment ◽  
Lung Perfusion ◽  
Limited Information ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Ex Vivo Lung Perfusion ◽  
Donor Lung ◽  
Lung Injuries ◽  
End Stage

Lung transplantation offers a lifesaving therapy for patients with end-stage lung disease but its availability is presently limited by low organ utilization rates with donor lungs frequently excluded due to unsuitability at assessment. When transplantation does occur, recipients are then vulnerable to primary graft dysfunction (PGD), multitudinous short-term complications, and chronic lung allograft dysfunction. The decision whether to use donor lungs is made rapidly and subjectively with limited information and means many lungs that might have been suitable are lost to the transplant pathway. Compared to static cold storage (SCS), ex vivo lung perfusion (EVLP) offers clinicians unrivalled opportunity for rigorous objective assessment of donor lungs in conditions replicating normal physiology, thus allowing for better informed decision-making in suitability assessments. EVLP additionally offers a platform for the delivery of intravascular or intrabronchial therapies to metabolically active tissue aiming to treat existing lung injuries. In the future, EVLP may be employed to provide a pre-transplant environment optimized to prevent negative outcomes such as primary graft dysfunction (PGD) or rejection post-transplant.

scholarly journals Ex vivo lung perfusion: how we do it

2021 ◽  
Author(s):  
John Santosh Murala ◽  
William Michael Whited ◽  
Amit Banga ◽  
Robert Castillo ◽  
Matthias Peltz ◽  
...  
Keyword(s):  
Operative Technique ◽  
Lung Transplant ◽  
Ex Vivo ◽  
Lung Perfusion ◽  
Donor Pool ◽  
Ex Vivo Lung Perfusion ◽  
Fda Approval ◽  
End Stage ◽  
Waitlist Mortality ◽  
Established Treatment

AbstractLung transplantation is an established treatment for patients with end-stage lung disease. However, a shortage of donors, low lung utilization among potential donors, and waitlist mortality continue to be challenges. In the last decade, ex vivo lung perfusion (EVLP) has expanded the donor pool by allowing prolonged evaluation of marginal donor lungs and allowing reparative therapies for lungs, which are otherwise considered not transplantable. In this review, we describe in detail our experience with EVLP including our workflow, setup, operative technique, and protocols. Our multidisciplinary EVLP program functions with the collaboration of surgeons, pulmonologists, and EVLP nurses who run the pump. EVLP program has been a valuable addition to our program. Since Food and Drug Administration (FDA) approval in 2019, we experienced incremental increased lung transplant volume of 12% annually.

scholarly journals Impact of Mobile Ex Vivo Lung Perfusion on Lung Transplant Finances

2021 ◽  
Vol 40 (4) ◽  
pp. S309-S310
Author(s):  
M. Urban ◽  
J. Boudreaux ◽  
H.M. Strah ◽  
B. Small ◽  
D. Berkheim ◽  
...  
Keyword(s):  
Lung Transplant ◽  
Ex Vivo ◽  
Lung Perfusion ◽  
Ex Vivo Lung Perfusion

Donation after Brain Death versus Donation after Circulatory Death: Lung Donor Management Issues

2018 ◽  
Vol 39 (02) ◽  
pp. 138-147 ◽  
Author(s):  
Bronwyn Levvey ◽  
Kovi Levin ◽  
Miranda Paraskeva ◽  
Glen Westall ◽  
Gregory Snell
Keyword(s):  
Brain Death ◽  
Ex Vivo ◽  
Scoring Systems ◽  
Donation After Circulatory Death ◽  
Donor Pool ◽  
Ex Vivo Lung Perfusion ◽  
Conversion Rates ◽  
Donor Lung ◽  
Donation After Brain Death ◽  
Circulatory Death

AbstractLung transplantation (LTx) has traditionally been limited by a lack of suitable donor lungs. With the recognition that lungs are more robust than initially thought, the size of the donor pool of available lungs has increased dramatically in the past decade. Donation after brain death (DBD) and donation after circulatory death (DCD) lungs, both ideal and extended are now routinely utilized. DBD lungs can be damaged. There are important differences in the public's understanding, legal and consent processes, intensive care unit strategies, lung pathophysiology, logistics, and potential-to-actual donor conversion rates between DBD and DCD. Notwithstanding, the short- and long-term outcomes of LTx from any of these DBD versus DCD donor scenarios are now similar, robust, and continue to improve. Large audits suggest there remains a large untapped pool of DCD (but not DBD) lungs that may yet further dramatically increase lung transplant numbers. Donor scoring systems that might predict the donor conversion rates and lung quality, the role of ex vivo lung perfusion as an assessment and lung resuscitation tool, as well as the potential of donor lung quality biomarkers all have immense promise for the clinical field.

Pro-IL-1β Is an Early Prognostic Indicator of Severe Donor Lung Injury During Ex Vivo Lung Perfusion

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Triin Major ◽  
Alexandra L. Ball ◽  
John P. Stone ◽  
Rebecca J. Edge ◽  
Gloria Lopez-Castejon ◽  
...  
Keyword(s):  
Lung Injury ◽  
Ex Vivo ◽  
Prognostic Indicator ◽  
Lung Perfusion ◽  
Ex Vivo Lung Perfusion ◽  
Donor Lung
Sign in / Sign up

Export Citation Format

Share Document