Functional assessment of non-heart-beating donor lungs: prediction of post-transplant function

Aitchison, J. D.; Orr, H. E.; Flecknell, P. A.; Kirby, John A.; Dark, John H.

doi:10.1016/s1010-7940(01)00723-0

Cited by 20 publications

(10 citation statements)

References 16 publications

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“…Blood gases provide additional information about graft oxygenation capacity during evaluation, 25 which seem to be predictive of gas exchange after transplantation. 60 Yeung et al 61 demonstrated that changes in airway pressures and pulmonary compliance can be used as early indicators of lung injury during EVLP, and this observation is in accordance with previous reports using the IPL. 23,25,26 To date, the Human Ex Vivo Lung Perfusion (HELP) study conducted by the Toronto lung transplant group is the only clinical trial that has prospectively evaluated the use of EVPLs before implantation.…”

Section: Testing Lung Viabilitysupporting

confidence: 79%

State of Art: Clinical ex vivo lung perfusion: Rationale, current status, and future directions

Sánchez¹,

Bittle²,

Burdorf³

et al. 2012

The Journal of Heart and Lung Transplantation

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Section: Testing Lung Viabilitysupporting

confidence: 79%

State of Art: Clinical ex vivo lung perfusion: Rationale, current status, and future directions

Sánchez¹,

Bittle²,

Burdorf³

et al. 2012

The Journal of Heart and Lung Transplantation

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“…A modification of vascular perfusion (hypothermic oxygen persufflation via the coronary artery) has been successfully adapted for lung preservation in porcine lung [102]. There are also proposals to use warm continuous perfusion for assessment of lung function after SCS [103]. However, these methods have yet to reach widespread application in the clinic.…”

Section: Lung Preservation By Hmpmentioning

confidence: 99%

Organ Preservation: Current Concepts and New Strategies for the Next Decade

Guibert

Petrenko

Balaban

et al. 2011

Transfus Med Hemother

286

233

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Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years.

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“…In renal grafts from NHBDs, pump perfusion has enhanced posttransplant graft function and also provided a rough measure (flow and resistance) of the expected function of the grafts after implantation. The development of comparable assays for lungs poses logistic and mechanical challenges; the feasibility of assessing gas exchange and circulation ex vivo has been demonstrated in porcine experiments (24,25) and also performed with human lungs (26) (27) has performed in vivo gas exchange evaluation in NHBDs to select lungs for transplant. If lungs can be retrieved from NHBDs and substantial numbers can be used for transplant, the shortage of lungs could be reduced.…”

Section: Inadequate Number Of Lungs For Transplantmentioning

confidence: 99%

Lung Transplantation: Opportunities for Research and Clinical Advancement

Wilkes¹

2006

Am J Respir Crit Care Med

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Lung transplantation is the only definitive therapy for many forms of end-stage lung diseases. However, the success of lung transplantation is limited by many factors: (1 ) Too few lungs available for transplantation due to limited donors or injury to the donor lung; (2 ) current methods of preservation of excised lungs do not allow extended periods of time between procurement and implantation; (3 ) acute graft failure is more common with lungs than other solid organs, thus contributing to poorer short-term survival after lung transplant compared with that for recipients of other organs; (4 ) lung transplant recipients are particularly vulnerable to pulmonary infections; and (5 ) chronic allograft dysfunction, manifest by bronchiolitis obliterans syndrome, is frequent and limits long-term survival. Scientific advances may provide significant improvements in the outcome of lung transplantation. The National Heart, Lung, and Blood Institute convened a working group of investigators on June 14-15, 2004, in Bethesda, Maryland, to identify opportunities for scientific advancement in lung transplantation, including basic and clinical research. This workshop provides a framework to identify critical issues related to clinical lung transplantation, and to delineate important areas for productive scientific investigation. Keywords: allograft dysfunction; infection; ischemia-reperfusion injury; lung transplantation; obliterative bronchiolitis; rejectionThe transplantation of organs offers the promise of life-saving and life-enhancing therapy for a variety of ailments. Lung transplantation (LTx) has become an acceptable therapy to palliate patients with a variety of end-stage lung diseases. However, lung transplantation has not turned out to be a panacea for chronic lung disease because of significant limitations in the entire transplant process (Figure 1). First, there are not nearly enough suitable donor lungs to meet the needs of all patients with end-stage lung disease. As a result, more patients die waiting for transplants than from mortality associated with a lung transplant. Second, early graft survival after LTx is worse than for other types of organs transplanted (1). Finally, late survival after successful LTx is hampered by the development of chronic allograft dysfunction and by the life-limiting complications associated with conventional immunosuppressive medications. Two factors impede progress to address these problems: (1 ) lung transplant centers lack the infrastructure to facilitate prospective, multicenter clinical studies of sufficient power to address clinical questions and (2 ) there are too few investigators studying the biology of lung transplantation.The NHLBI convened a workshop on June 14-15, 2004, to better understand these complex problems and to identify strategies to address these and prioritize them. The topics addressed by participants were wide-ranging. They included the following: lung use rates from conventional brain-dead organ donors; safe limits for donor lung function; consideration o...

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Functional assessment of non-heart-beating donor lungs: prediction of post-transplant function

Cited by 20 publications

References 16 publications

State of Art: Clinical ex vivo lung perfusion: Rationale, current status, and future directions

State of Art: Clinical ex vivo lung perfusion: Rationale, current status, and future directions

Organ Preservation: Current Concepts and New Strategies for the Next Decade

Lung Transplantation: Opportunities for Research and Clinical Advancement

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