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

机译：扩展标准供体肺修复与器官护理系统肺部：单一机构经验

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摘要

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 (TM) 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 (TM) 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/FiO(2) 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 (TM) Lung; a prospective trial is underway to validate its role to safely increase the number of donor lungs.
机译：肺移植是捐助者可用性有限的救生程序。 ExVivo肺灌注的肺修复代表膨胀供体池的工具。在这项研究中，我们描述了我们对ocs（TM）肺的经验，以评估和修复扩展标准肺部。从2014年1月到2016年10月，评估了86个现场捐助者，已鉴定出8种肺部潜在的肺部（TM）肺部。我们分析了从这些捐赠者和移植后的受体结果的数据。所有供体肺在OCS灌注中都会改善，特别是关于PAO2 / FIO（2）比（从供体中的340mmHg到OC等537mmHg），导致肺部移植。关于术后结果，在一名患者中观察到72小时的初级移植物功能障碍3分，而中位机械通风时间，ICU和住院入住分别为60小时，14和36天。记录了一个住院死亡（12.5％），而其他两名患者在后续行动期间死亡，导致1年的存活率为62.5％。剩下的五名患者在良好的情况下是活力的。本案例系列展示了用OCS（TM）肺重新处理的可行性和价值;正在进行一项潜在的试验，以验证其在安全增加供体肺的数量的作用。

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