Extended criteria donor organ use for heart-lung transplantation in the modern era

Weingarten, Noah; Iyengar, Amit; Herbst, D. Alan; Helmers, Mark R.; Meldrum, Danika; Guevara-Plunkett, Sara; Dominic, Jessica; Atluri, Pavan

doi:10.1016/j.clinsp.2023.100205

Cited by 1 publication

(1 citation statement)

References 21 publications

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“…A list of extended donor criteria for heart and lungs is presented as the following [ 15 ]: extended heart criteria; (1) age >55 years, (2) cold ischemic time >360 minutes, (3) donor/recipient weight ratio <0.80 or ≥1.30, (4) hepatitis C positivity, (5) drug use history, (6) renal insufficiency (serum creatinine >2.0 mg/dL), (7) left ventricular ejection fraction <50%, and (8) DCD. Extended lung criteria: (1) age ≥55 years, (2) infiltrates on chest radiograph, (3) PaO 2 /FiO 2 ratio (P/F ratio) <300 at a fraction of inspired oxygen (FiO 2 ) of 1.0 and positive end-expiratory pressure (PEEP) of 5 cmH 2 O, (4) purulent secretions on bronchoscopy or evidence of aspiration/sepsis, and (5) cigarette use history (>20 pack-years).…”

Section: Introductionmentioning

confidence: 99%

Ex vivo lung perfusion and the Organ Care System: a review

Attawar,

et al. 2024

Clin Transplant Res

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With the increasing prevalence of heart failure and end-stage lung disease, there is a sustained interest in expanding the donor pool to alleviate the thoracic organ shortage crisis. Efforts to extend the standard donor criteria and to include donation after circulatory death have been made to increase the availability of suitable organs. Studies have demonstrated that outcomes with extended-criteria donors are comparable to those with standard-criteria donors. Another promising approach to augment the donor pool is the improvement of organ preservation techniques. Both ex vivo lung perfusion (EVLP) for the lungs and the Organ Care System (OCS, TransMedics) for the heart have shown encouraging results in preserving organs and extending ischemia time through the application of normothermic regional perfusion. EVLP has been effective in improving marginal or borderline lungs by preserving and reconditioning them. The use of OCS is associated with excellent short-term outcomes for cardiac allografts and has improved utilization rates of hearts from extended-criteria donors. While both EVLP and OCS have successfully transitioned from research to clinical practice, the costs associated with commercially available systems and consumables must be considered. The ex vivo perfusion platform, which includes both EVLP and OCS, holds the potential for diverse and innovative therapies, thereby transforming the landscape of thoracic organ transplantation.

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Section: Introductionmentioning

confidence: 99%

Ex vivo lung perfusion and the Organ Care System: a review

Attawar,

et al. 2024

Clin Transplant Res

View full text Add to dashboard Cite

show abstract

Extended criteria donor organ use for heart-lung transplantation in the modern era

Cited by 1 publication

References 21 publications

Ex vivo lung perfusion and the Organ Care System: a review

Ex vivo lung perfusion and the Organ Care System: a review

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