Clinical Outcomes of the Lund, Toronto, and Organ Care System Protocols for Normothermic Ex Vivo Lung Perfusion: A Systematic Review and Pursuit of Network Meta-Analysis

Knijff, Emily S X; Hu, Mingzhi; Zhang, Z.L.; Erasmus, Michiel E.

doi:10.1016/j.healun.2021.01.874

Cited by 1 publication

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“…Since all studies investigating these protocols compare outcomes to SCS, no direct comparison between protocols can be made. Moreover, differences in study design, lung transplant type, and patient characteristics do not allow for statistically significant comparisons between these protocols ( 125 ). Noteworthy, experimental studies have also investigated lower flow rates comparing EVMP flows of 40%–20% in porcine DCD lungs.…”

Section: Ex Situ Machine Perfusionmentioning

confidence: 99%

Pushing the boundaries of innovation: the potential of ex vivo organ perfusion from an interdisciplinary point of view

Iske,

Schroeter,

Knoedler

et al. 2023

Front. Cardiovasc. Med.

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Ex vivo machine perfusion (EVMP) is an emerging technique for preserving explanted solid organs with primary application in allogeneic organ transplantation. EVMP has been established as an alternative to the standard of care static-cold preservation, allowing for prolonged preservation and real-time monitoring of organ quality while reducing/preventing ischemia–reperfusion injury. Moreover, it has paved the way to involve expanded criteria donors, e.g., after circulatory death, thus expanding the donor organ pool. Ongoing improvements in EVMP protocols, especially expanding the duration of preservation, paved the way for its broader application, in particular for reconditioning and modification of diseased organs and tumor and infection therapies and regenerative approaches. Moreover, implementing EVMP for in vivo-like preclinical studies improving disease modeling raises significant interest, while providing an ideal interface for bioengineering and genetic manipulation. These approaches can be applied not only in an allogeneic and xenogeneic transplant setting but also in an autologous setting, where patients can be on temporary organ support while the diseased organs are treated ex vivo, followed by reimplantation of the cured organ. This review provides a comprehensive overview of the differences and similarities in abdominal (kidney and liver) and thoracic (lung and heart) EVMP, focusing on the organ-specific components and preservation techniques, specifically on the composition of perfusion solutions and their supplements and perfusion temperatures and flow conditions. Novel treatment opportunities beyond organ transplantation and limitations of abdominal and thoracic EVMP are delineated to identify complementary interdisciplinary approaches for the application and development of this technique.

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Section: Ex Situ Machine Perfusionmentioning

confidence: 99%