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Ten year follow-up of lung transplantations using initially rejected donor lungs after reconditioning using ex vivo lung perfusion

Ghaidan, Haider LU ; Fakhro, Mohammed LU ; Andreasson, Jesper LU ; Pierre, Leif LU ; Ingemansson, Richard LU and Lindstedt, Sandra LU (2019) In Journal of Cardiothoracic Surgery 14(1).
Abstract

Background: In 2006 and 2007 we performed double lung transplantation with marginal donor lungs assessed and reconditioned by Ex Vivo Lung Perfusion (EVLP), using a technique developed by Professor Stig Steen. Here we present a 10-year follow-up comparing the outcomes of lung transplantations performed at our clinic using EVLP lungs vs. conventional lungs. Method: Between 2006 and 2007, 21 patients (6 EVLP, 15 conventional) underwent double lung transplantation (LTx) with follow-up on May 2017 at Lund University Hospital, Sweden. Pulmonary function was measured at 3/6/12 months, and annually thereafter for a period of 10 years in addition to survival and freedom from chronic lung allograft dysfunction (CLAD) being analyzed. Results:... (More)

Background: In 2006 and 2007 we performed double lung transplantation with marginal donor lungs assessed and reconditioned by Ex Vivo Lung Perfusion (EVLP), using a technique developed by Professor Stig Steen. Here we present a 10-year follow-up comparing the outcomes of lung transplantations performed at our clinic using EVLP lungs vs. conventional lungs. Method: Between 2006 and 2007, 21 patients (6 EVLP, 15 conventional) underwent double lung transplantation (LTx) with follow-up on May 2017 at Lund University Hospital, Sweden. Pulmonary function was measured at 3/6/12 months, and annually thereafter for a period of 10 years in addition to survival and freedom from chronic lung allograft dysfunction (CLAD) being analyzed. Results: Regarding Forced Expiratory Volume in 1 s (FEV1) and 6MWT at 3, 6, and 12 months and annually thereafter, no difference in median FEV1 nor 6MWT was found for EVLP-LTx vs. conventional-LTx (p > 0.05). No difference was shown in post-operative survival between EVLP-LTx vs. conventional LTx for patients with an overall survival up to 10-years (p > 0.05). The same pattern was shown in sub analyses for patients with a limited survival up to 1 and 5 years (p > 0.05). Conclusion: No superiority was found in conventional-LTx over EVLP-LTx, neither in long-term survival nor pulmonary function. No difference in CLAD-free survival was seen between the two groups. We believe that EVLP is a safe and effective method to use in LTx, greatly increasing the donor pool by improving marginal lungs and providing an objective assessment of the viability of marginal donor lungs.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
EVLP, Long-term follow up, Lung function, Lung transplantation, Survival
in
Journal of Cardiothoracic Surgery
volume
14
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85068529548
ISSN
1749-8090
DOI
10.1186/s13019-019-0948-1
language
English
LU publication?
yes
id
2ce1b640-59f0-445a-a0ff-83bd4ab0c53d
date added to LUP
2019-07-16 14:35:30
date last changed
2019-08-14 04:41:48
@article{2ce1b640-59f0-445a-a0ff-83bd4ab0c53d,
  abstract     = {<p>Background: In 2006 and 2007 we performed double lung transplantation with marginal donor lungs assessed and reconditioned by Ex Vivo Lung Perfusion (EVLP), using a technique developed by Professor Stig Steen. Here we present a 10-year follow-up comparing the outcomes of lung transplantations performed at our clinic using EVLP lungs vs. conventional lungs. Method: Between 2006 and 2007, 21 patients (6 EVLP, 15 conventional) underwent double lung transplantation (LTx) with follow-up on May 2017 at Lund University Hospital, Sweden. Pulmonary function was measured at 3/6/12 months, and annually thereafter for a period of 10 years in addition to survival and freedom from chronic lung allograft dysfunction (CLAD) being analyzed. Results: Regarding Forced Expiratory Volume in 1 s (FEV1) and 6MWT at 3, 6, and 12 months and annually thereafter, no difference in median FEV1 nor 6MWT was found for EVLP-LTx vs. conventional-LTx (p &gt; 0.05). No difference was shown in post-operative survival between EVLP-LTx vs. conventional LTx for patients with an overall survival up to 10-years (p &gt; 0.05). The same pattern was shown in sub analyses for patients with a limited survival up to 1 and 5 years (p &gt; 0.05). Conclusion: No superiority was found in conventional-LTx over EVLP-LTx, neither in long-term survival nor pulmonary function. No difference in CLAD-free survival was seen between the two groups. We believe that EVLP is a safe and effective method to use in LTx, greatly increasing the donor pool by improving marginal lungs and providing an objective assessment of the viability of marginal donor lungs.</p>},
  articleno    = {125},
  author       = {Ghaidan, Haider and Fakhro, Mohammed and Andreasson, Jesper and Pierre, Leif and Ingemansson, Richard and Lindstedt, Sandra},
  issn         = {1749-8090},
  keyword      = {EVLP,Long-term follow up,Lung function,Lung transplantation,Survival},
  language     = {eng},
  month        = {07},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Journal of Cardiothoracic Surgery},
  title        = {Ten year follow-up of lung transplantations using initially rejected donor lungs after reconditioning using ex vivo lung perfusion},
  url          = {http://dx.doi.org/10.1186/s13019-019-0948-1},
  volume       = {14},
  year         = {2019},
}