Cadaver lung donors: Effect of preharvest ventilation on graft function

Ulicny, Karl S.; Egan, Thomas M.; Lambert, Cary J.; Reddick, Robert L.; Wilcox, Benson R.

doi:10.1016/0003-4975(93)90031-c

Cited by 86 publications

(41 citation statements)

References 21 publications

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“…Ventilation was resumed with 7 mL/kg, PEEP 5 cm H 2 O, 7 breaths/minute and 30% FiO 2 when a temperature of 338C was reached. Decision as to whether to transplant the lungs or not was made based on sequential hourly assessments (with ventilation increased to 10 mL/kg, 10 breaths/minute and 100% FiO 2 for 5 minutes prior to each assessment) comprised of pulmonary artery pressure, pulmonary compliance, airway pressures and perfusate pO 2 . Chest x-ray and bronchoscopic evaluation performed at 1 hour and 3 hours were also used in the decisionmaking process.…”

Section: Ex Vivo Lung Perfusion (Evlp)mentioning

confidence: 99%

“…His group initially showed that non-ventilated canine lungs procured 1 hour after cardiac arrest could sustain life for at least 8 hours once transplanted into a recipient with the contra-lateral pulmonary artery ligated (1). The same group further highlighted the importance of oxygen ventilation in order to maintain cell viability for hours after circulatory arrest (2,3). Clinically, successful lung transplantation (LTx) using controlled DCDDs was first reported by Love et al, in 1993 (4).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Machuca

Mercier

Collaud

et al. 2015

American Journal of Transplantation

130

116

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The growing demand for suitable lungs for transplantation drives the quest for alternative strategies to expand the donor pool. The aim of this study is to evaluate the outcomes of lung transplantation (LTx) with donation after circulatory determination of death (DCDD) and the impact of selective ex vivo lung perfusion (EVLP). From 2007 to 2013, 673 LTx were performed, with 62 (9.2%) of them using DCDDs (seven bridged cases). Cases bridged with mechanical ventilation/extracorporeal life support were excluded. From 55 DCDDs, 28 (51%) underwent EVLP. Outcomes for LTx using DCDDs and donation after neurological determination of death (DNDD) donors were similar, with 1 and 5-year survivals of 85% and 54% vs 86% and 62%, respectively (p ¼ 0.43). Although comparison of survival curves between DCDD þ EVLP vs DCDD-no EVLP showed no significant difference, DCDD þ EVLP cases presented shorter hospital stay (median 18 vs. 23 days, p ¼ 0.047) and a trend toward shorter length of mechanical ventilation (2 vs. 3 days, p ¼ 0.059). DCDDs represent a valuable source of lungs for transplantation, providing similar results to DNDDs. EVLP seems an important technique in the armamentarium to safely increase lung utilization from DCDDs; however, further studies are necessary to better define the role of EVLP in this context.

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Section: Ex Vivo Lung Perfusion (Evlp)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Machuca

Mercier

Collaud

et al. 2015

American Journal of Transplantation

130

116

View full text Add to dashboard Cite

show abstract

“…Because the majority of patients succumb as a result of cardiac arrest, the use of DCDs could potentially open a completely new pool of donor organs of such magnitude that ultimately the entire demand could be met. Renewed interest in the potential use of lungs from DCDs followed a series of experiments in dogs by Egan and coworkers in the early nineties (Egan et al 1991;Ulicny et al 1993). His group showed that lung cells remain viable for a certain period after circulatory arrest (Alessandrini et al 1994;D'Armini et al 1994).…”

Section: Donation After Cardiac Deathmentioning

confidence: 99%

Overview of Clinical Lung Transplantation

Yeung

Keshavjee

2014

Cold Spring Harbor Perspectives in Medicine

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Since the first successful lung transplant 30 years ago, lung transplantation has rapidly become an established standard of care to treat end-stage lung disease in selected patients. Advances in lung preservation, surgical technique, and immunosuppression regimens have resulted in the routine performance of lung transplantation around the world for an increasing number of patients, with wider indications. Despite this, donor shortages and chronic lung allograft dysfunction continue to prevent lung transplantation from reaching its full potential. With research into the underlying mechanisms of acute and chronic lung graft dysfunction and advances in personalized diagnostic and therapeutic approaches to both the donor lung and the lung transplant recipient, there is increasing confidence that we will improve short-and long-term outcomes in the near future.

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“…In a dog model, Ulicny et al retrieved lungs 4 h after death from ventilated DCD donors (34). Four of six recipients of oxygen-ventilated cadaver lungs survived 8 h with good gas exchange whereas two of six recipients of non-ventilated lungs survived with poor gas exchange.…”

Section: Proof Of Concept and Experimental Backgroundmentioning

confidence: 99%

Donors after cardiocirculatory death and lung transplantation

İnci

2017

J. Thorac. Dis.

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Abstract:The number of patients actively awaiting lung transplantation (LTx) is more than the number of suitable donor lungs. The percentage of lung retrieval rate is lower when compared to other solid organs.The use of lungs from donation after cardiocirculatory death (DCD) donors is one of the options to avoid organ shortage in LTx. After extensive experimental research, clinical application of DCD donation is becoming wider. The results from most of the centers show at least equal survival rate compared to donors from brain death. This review paper will summarize experimental background and clinical experience from DCD donors.

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Cadaver lung donors: Effect of preharvest ventilation on graft function

Cited by 86 publications

References 21 publications

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Lung Transplantation With Donation After Circulatory Determination of Death Donors and the Impact of Ex Vivo Lung Perfusion

Overview of Clinical Lung Transplantation

Donors after cardiocirculatory death and lung transplantation

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