Extended criteria donor lung reconditioning with the organ care system lung: a single institution experience

Abstract

Summary Lung transplantation is a life‐saving procedure limited by donor's availability. Lung reconditioning by ex vivo lung perfusion represents a tool to expand the donor pool. In this study, we describe our experience with the OCS™ Lung to assess and recondition extended criteria lungs. From January 2014 to October 2016, of 86 on‐site donors evaluated, eight lungs have been identified as potentially treatable with OCS™ Lung. We analyzed data from these donors and the recipient outcomes after transplantation. All donor lungs improved during OCS perfusion in particular regarding the PaO2/FiO2 ratio (from 340 mmHg in donor to 537 mmHg in OCS) leading to lung transplantation in all cases. Concerning postoperative results, primary graft dysfunction score 3 at 72 h was observed in one patient, while median mechanical ventilation time, ICU, and hospital stay were 60 h, 14 and 36 days respectively. One in‐hospital death was recorded (12.5%), while other two patients died during follow‐up leading to 1‐year survival of 62.5%. The remaining five patients are alive and in good conditions. This case series demonstrates the feasibility and value of lung reconditioning with the OCS™ Lung; a prospective trial is underway to validate its role to safely increase the number of donor lungs.

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

“…Steen Solution -это раствор, содержащий декстран и альбумин, имитирующий концентрации внеклеточных электролитов [8,14,15]. OCS Lung Solution -это аналогичный буферный раствор, содержащий декстран вместо альбумина [5,8,20,21].…”

Donation after circulatory death program in Italy

“…The advent of EVLP provided a fundamental tool for lung transplantation centres, allowing for detailed assessment and reconditioning of lungs. In Italy, machine perfusion protocols vary among centres (8,9). In our centre in Milan, we perform a 4-hour-long normothermic EVLP with an open atrium technique, using a perfusion solution made of both Steen solution and red blood cells (reaching a 5-10% haematocrit) and maintaining the target flow at 40% of the estimated donor's cardiac output, as previously described (Figure 4) (10).…”

Ex vivo lung perfusion prior to transplantation: an overview of current clinical practice worldwide

“…In most of the reports, outcome was compared with a control group showing no major difference between reconditioned and standard lungs except in the experience reported from Denmark, Padova (34) and Vienna 2012. In many reports total cross clamp time (including cold and warm ischemic times) in EVLP transplants was greater compared to cold stored lungs.…”