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Start Over Author "Bando T" Journal journal of heart & lung transplantation
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9. 91 Reconditioning of Lungs from Non-Heart-Beating Donors with Normothermic Ex Vivo Lung Perfusion

Author

Nakajima, D., Yamada, T., Chen, F., Sakamoto, J., Ohsumi, A., Fujinaga, T., Shoji, T., Sakai, H., Bando, T., and Date, H.

Subjects
*NON-heart-beating organ donation, *REPERFUSION, *LUNG transplantation, *PULMONARY function tests, *BEAGLE (Dog breed), *LABORATORY dogs, *PULMONARY edema
Abstract

Purpose: To resolve the shortage of donor lungs, the use of non-heart-beating donors (NHBD) has come into practice. An ideal method of preservation that can improve the quality of NHBD lungs has been investigated. Normothermic ex vivo lung perfusion (EVLP) enables organ viability assessment before transplantation. In this study, we investigated whether NHBD lungs can be resuscitated after warm ischemia by normothermic EVLP. Methods and Materials: Four hours after cardiac arrest, the beagles were allocated into 2 groups (n=6 each): static cold storage (SCS) or normothermic EVLP using STEEN solution for 3.5 h. The physiological lung functions were evaluated during normothermic EVLP. In both groups, left lungs were then transplanted and reperfused for 4 h to investigate posttransplant lung functions. Results: In each group, one beagle has died due to severe pulmonary edema after 2 h of reperfusion. Lung oxygenation significantly improved with normothermic EVLP (p<0.01), and lung oxygenation at the end of EVLP reflected lung oxygenation at the end of reperfusion (R=0.99, p<0.01). In details, PaO2 at the beginning, the end of EVLP, and 4 h of reperfusion were 437±68 mmHg, 558±35 mmHg, and 576±63 mmHg, respectively. Other lung functions (dynamic pulmonary compliance, peak airway pressure, pulmonary vascular resistance) were stable during EVLP. The posttransplant oxygenation in the EVLP group was significantly better than that in the SCS group (p<0.05). The dynamic pulmonary compliance at 4 h of reperfusion in the EVLP group was significantly better than that in the SCS group (EVLP 13.02±0.99 ml/mmHg, SCS 11.26±0.99 ml/mmHg; p<0.05). The wet to dry lung weight ratio in the EVLP group was significantly lower than that in the SCS group (EVLP 6.30±0.54, SCS 10.92±0.86; p<0.01). Conclusions: Normothermic ex vivo lung perfusion could resuscitate NHBD lungs injured by 4 h of warm ischemia. [ABSTRACT FROM AUTHOR]

Published
2011
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