BACKGROUND: A major problem in clinical lung transplantation is the shortage of donor lungs. Only about 20% of donor lungs are accepted for transplantation. A method to evaluate and recondition lungs ex vivo has been tested on donor lungs that have been rejected for transplantation. METHODS: The donor lungs were reconditioned ex vivo in an extracorporeal membrane oxygenation (ECMO) circuit with STEEN solution (Vitrolife AB, Kungsbacka, Sweden) mixed with erythrocytes. The hyperoncotic solution dehydrates edematous lung tissue. Functional evaluations were performed with deoxygenated perfusate by varying the inspired fraction of oxygen. After the reconditioning, the lungs were kept immersed at 8 degrees C in extracorporeal membrane oxygenation until transplantation was performed. RESULTS: Six of nine initially rejected donor lungs were reconditioned to acceptable function, and in six recipients, double lung transplantation was performed. Three-month survival was 100%. One patient has since died due to sepsis after 95 days, and one due to rejection after 9 months. Four recipients are alive and well without any sign of bronchiolitis obliterans syndrome 24 months after the transplantation. CONCLUSIONS: The result from the present study is promising, and we continue to transplant reconditioned lungs.
BACKGROUND: A major problem in clinical lung transplantation is the shortage of donor lungs. Only about 20% of donor lungs are accepted for transplantation. A method to evaluate and recondition lungs ex vivo has been tested on donor lungs that have been rejected for transplantation. METHODS: The donor lungs were reconditioned ex vivo in an extracorporeal membrane oxygenation (ECMO) circuit with STEEN solution (Vitrolife AB, Kungsbacka, Sweden) mixed with erythrocytes. The hyperoncotic solution dehydrates edematous lung tissue. Functional evaluations were performed with deoxygenated perfusate by varying the inspired fraction of oxygen. After the reconditioning, the lungs were kept immersed at 8 degrees C in extracorporeal membrane oxygenation until transplantation was performed. RESULTS: Six of nine initially rejected donor lungs were reconditioned to acceptable function, and in six recipients, double lung transplantation was performed. Three-month survival was 100%. One patient has since died due to sepsis after 95 days, and one due to rejection after 9 months. Four recipients are alive and well without any sign of bronchiolitis obliterans syndrome 24 months after the transplantation. CONCLUSIONS: The result from the present study is promising, and we continue to transplant reconditioned lungs.
Authors: Don Hayes; Benjamin T Kopp; Stephen E Kirkby; Susan D Reynolds; Heidi M Mansour; Joseph D Tobias; Dmitry Tumin Journal: Lung Date: 2016-06-08 Impact factor: 2.584
Authors: Samuel Jacob; Andrew Courtwright; Souheil El-Chemaly; Emilian Racila; Miguel Divo; Patrick Burkett; Anne Fuhlbrigge; Hilary J Goldberg; Ivan O Rosas; Phillip Camp Journal: Eur J Cardiothorac Surg Date: 2015-10-14 Impact factor: 4.191
Authors: A Venkataraman; J W Blackwell; W K Funkhouser; K R Birchard; S E Beamer; W T Simmons; S H Randell; T M Egan Journal: Transplant Proc Date: 2017-09 Impact factor: 1.066
Authors: Michael S Mulvihill; Brian C Gulack; Asvin M Ganapathi; Paul J Speicher; Brian R Englum; Sameer A Hirji; Laurie D Snyder; R Duane Davis; Matthew G Hartwig Journal: Clin Transplant Date: 2017-06-01 Impact factor: 2.863
Authors: Timothy J George; George J Arnaoutakis; Claude A Beaty; Simran K Jandu; Lakshmi Santhanam; Dan E Berkowitz; Ashish S Shah Journal: J Surg Res Date: 2012-11-27 Impact factor: 2.192