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Clinical transplantation of initially rejected donor lungs after reconditioning ex vivo.

Ingemansson, Richard LU ; Eyjolfsson, Atli LU ; Mared, Lena LU ; Pierre, Leif LU ; Algotsson, Lars LU ; Ekmehag, Björn LU ; Gustafsson, Ronny LU ; Johnsson, Per; Koul, Bansi LU and Lindstedt Ingemansson, Sandra LU , et al. (2009) In Annals of Thoracic Surgery 87(1). p.255-260
Abstract
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... (More)
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. (Less)
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in
Annals of Thoracic Surgery
volume
87
issue
1
pages
255 - 260
publisher
Elsevier
external identifiers
  • wos:000261834000056
  • pmid:19101308
  • scopus:57649237744
ISSN
1552-6259
DOI
10.1016/j.athoracsur.2008.09.049
language
English
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yes
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27a65011-4bf1-435a-ac27-841acb06715d (old id 1275985)
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http://www.ncbi.nlm.nih.gov/pubmed/19101308?dopt=Abstract
date added to LUP
2009-01-09 12:40:43
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2017-11-05 04:40:19
@article{27a65011-4bf1-435a-ac27-841acb06715d,
  abstract     = {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.},
  author       = {Ingemansson, Richard and Eyjolfsson, Atli and Mared, Lena and Pierre, Leif and Algotsson, Lars and Ekmehag, Björn and Gustafsson, Ronny and Johnsson, Per and Koul, Bansi and Lindstedt Ingemansson, Sandra and Lührs, Carsten and Sjöberg, Trygve and Steen, Stig},
  issn         = {1552-6259},
  language     = {eng},
  number       = {1},
  pages        = {255--260},
  publisher    = {Elsevier},
  series       = {Annals of Thoracic Surgery},
  title        = {Clinical transplantation of initially rejected donor lungs after reconditioning ex vivo.},
  url          = {http://dx.doi.org/10.1016/j.athoracsur.2008.09.049},
  volume       = {87},
  year         = {2009},
}