Addressing donor-organ shortages using extended criteria in lung transplantation

Neizer, Hannah; Singh, Gaurev B.; Gupta, Shubham; Singh, Steve K.

doi:10.21037/acs.2019.10.01

Cited by 24 publications

(12 citation statements)

References 9 publications

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“…Focusing on expanding the donor pool to reduce the mortality of lung transplant in recipient patients, different approaches are currently being explored, including the extended criteria for the selection of donors [ 153 ], and lung procurement from donors after cardiac death [ 3 ]. These strategies have led to the use of the so-called “marginal” organs that do not fulfill the standard criteria of donor lungs.…”

Section: Mesenchymal Stromal/stem Cell (Msc)-based Therapeutic Approa...mentioning

confidence: 99%

Mesenchymal Stromal/Stem Cells and Their Products as a Therapeutic Tool to Advance Lung Transplantation

Miceli

Bertani

2022

Cells

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Lung transplantation (LTx) has become the gold standard treatment for end-stage respiratory failure. Recently, extended lung donor criteria have been applied to decrease the mortality rate of patients on the waiting list. Moreover, ex vivo lung perfusion (EVLP) has been used to improve the number/quality of previously unacceptable lungs. Despite the above-mentioned progress, the morbidity/mortality of LTx remains high compared to other solid organ transplants. Lungs are particularly susceptible to ischemia-reperfusion injury, which can lead to graft dysfunction. Therefore, the success of LTx is related to the quality/function of the graft, and EVLP represents an opportunity to protect/regenerate the lungs before transplantation. Increasing evidence supports the use of mesenchymal stromal/stem cells (MSCs) as a therapeutic strategy to improve EVLP. The therapeutic properties of MSC are partially mediated by secreted factors. Hence, the strategy of lung perfusion with MSCs and/or their products pave the way for a new innovative approach that further increases the potential for the use of EVLP. This article provides an overview of experimental, preclinical and clinical studies supporting the application of MSCs to improve EVLP, the ultimate goal being efficient organ reconditioning in order to expand the donor lung pool and to improve transplant outcomes.

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Section: Mesenchymal Stromal/stem Cell (Msc)-based Therapeutic Approa...mentioning

confidence: 99%

Mesenchymal Stromal/Stem Cells and Their Products as a Therapeutic Tool to Advance Lung Transplantation

Miceli

Bertani

2022

Cells

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show abstract

“…Strategies to increase the number of available organs include the use of extendedcriteria donors, generation of bioengineered lung grafts, development of genetically modified swine lung xenografts, and extracorporeal recovery of donor lungs using isolated or cross-circulation ex vivo lung perfusion (EVLP). [1][2][3][4][5] Isolated EVLP (ie, machine perfusion) has proved the feasibility of reconditioning donor organs and enabled transplantation of hundreds of marginal lungs. Nevertheless, despite all efforts, the number of lung transplants has only modestly increased.…”

Section: Jules Lin MDmentioning

confidence: 99%

Xenogeneic support for the recovery of human donor organs

O’Neill

Guenthart

Hozain

et al. 2022

The Journal of Thoracic and Cardiovascular Surgery

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“…An ideal or standard donor criteria (SDC) guidelines (Table 1) were originally drafted in 1993 [4], and have remained largely unchanged since then [5]. Extended donor criteria (EDC) refers to the use of donor lungs that do not meet the standard criteria for transplantation; however, EDC does not imply marginal or sub-standard quality [6]. The definition of EDC is not uniform and varies among institutes [7][8][9].…”

Section: Donor Quality Assessmentmentioning

confidence: 99%

“…High priority is always given to the patients having the highest lung allocation score, who are likely to die without transplant and less likely to survive the operation. These patients are likely to provide consent for EDC use [6]. However, low priority candidates (lung allocation score < 50), comprising of a majority of transplant recipients, demonstrates lesser survival benefit compared to midpriority candidates (Lung Allocation Score 50-79) given the low risk of death on waiting list [61].…”

Section: Ethicsmentioning

confidence: 99%