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Is it possible to further improve the function of pulmonary grafts by extending the duration of lung reconditioning using ex vivo lung perfusion?

Pierre, Leif LU ; Lindstedt Ingemansson, Sandra LU ; Hlebowicz, Joanna LU and Ingemansson, Richard LU (2013) In Perfusion 28(4). p.322-327
Abstract
BACKGROUND: The method of ex vivo lung perfusion (EVLP) has been suggested as a reliable means of differentiating between "good" and "poor" pulmonary grafts in marginal donors as, when grafts identified as good by this method are transplanted, the results do not differ from those using lungs fulfilling standard criteria. The EVLP method is also thought to improve pulmonary grafts by reducing lung edema and eliminating lung atelectasis. In the present study, we investigated whether the pulmonary graft could be further improved by extending the duration of EVLP.Methods and Materials:Six Landrace pigs were used. The lungs were reconditioned and evaluated, using the EVLP method, as double lungs. After the initial evaluation, EVLP was continued... (More)
BACKGROUND: The method of ex vivo lung perfusion (EVLP) has been suggested as a reliable means of differentiating between "good" and "poor" pulmonary grafts in marginal donors as, when grafts identified as good by this method are transplanted, the results do not differ from those using lungs fulfilling standard criteria. The EVLP method is also thought to improve pulmonary grafts by reducing lung edema and eliminating lung atelectasis. In the present study, we investigated whether the pulmonary graft could be further improved by extending the duration of EVLP.Methods and Materials:Six Landrace pigs were used. The lungs were reconditioned and evaluated, using the EVLP method, as double lungs. After the initial evaluation, EVLP was continued for a further 90 minutes. RESULTS: The arterial oxygen level (pO(2)) was 60.8 ± 4.8 kPa after the standard 60 minutes of EVLP and 67.1 ± 2.2 kPa after 150 minutes (p = 0.48). The pulmonary vascular resistance was 453 ± 78 dyne*s/cm(5) after 60, 90, 120 and 150 minutes of EVLP (p = 1.0). The pulmonary artery pressure was 17.8 ± 1.0 mmHg after 60, 90, 120, and 150 minutes of EVLP (p = 1.0) and the pulmonary artery flow was 3.5 ± 0.4 l/min after 60, 90, 120, and 150 minutes of EVLP (p = 1.0). The mean weight of the pulmonary grafts after harvesting was 574 ± 20 g at the beginning of EVLP 541 ± 24 g and, after 150 min of EVLP, 668 ± 33 (p = 0.011). CONCLUSIONS: The blood gases and hemodynamic parameters in the pulmonary grafts did not improve as a result of the extra 90 minutes of EVLP. However, the weight of the pulmonary graft increased significantly with increasing duration of EVLP, indicating lung perfusion injury. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Perfusion
volume
28
issue
4
pages
322 - 327
publisher
SAGE Publications Inc.
external identifiers
  • wos:000320697600008
  • pmid:23436723
  • scopus:84879375497
ISSN
1477-111X
DOI
10.1177/0267659113479424
language
English
LU publication?
yes
id
4dd56675-4696-44cb-bf5c-febd14e0d4d8 (old id 3559475)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23436723?dopt=Abstract
date added to LUP
2013-03-01 13:12:37
date last changed
2019-02-20 01:05:48
@article{4dd56675-4696-44cb-bf5c-febd14e0d4d8,
  abstract     = {BACKGROUND: The method of ex vivo lung perfusion (EVLP) has been suggested as a reliable means of differentiating between "good" and "poor" pulmonary grafts in marginal donors as, when grafts identified as good by this method are transplanted, the results do not differ from those using lungs fulfilling standard criteria. The EVLP method is also thought to improve pulmonary grafts by reducing lung edema and eliminating lung atelectasis. In the present study, we investigated whether the pulmonary graft could be further improved by extending the duration of EVLP.Methods and Materials:Six Landrace pigs were used. The lungs were reconditioned and evaluated, using the EVLP method, as double lungs. After the initial evaluation, EVLP was continued for a further 90 minutes. RESULTS: The arterial oxygen level (pO(2)) was 60.8 ± 4.8 kPa after the standard 60 minutes of EVLP and 67.1 ± 2.2 kPa after 150 minutes (p = 0.48). The pulmonary vascular resistance was 453 ± 78 dyne*s/cm(5) after 60, 90, 120 and 150 minutes of EVLP (p = 1.0). The pulmonary artery pressure was 17.8 ± 1.0 mmHg after 60, 90, 120, and 150 minutes of EVLP (p = 1.0) and the pulmonary artery flow was 3.5 ± 0.4 l/min after 60, 90, 120, and 150 minutes of EVLP (p = 1.0). The mean weight of the pulmonary grafts after harvesting was 574 ± 20 g at the beginning of EVLP 541 ± 24 g and, after 150 min of EVLP, 668 ± 33 (p = 0.011). CONCLUSIONS: The blood gases and hemodynamic parameters in the pulmonary grafts did not improve as a result of the extra 90 minutes of EVLP. However, the weight of the pulmonary graft increased significantly with increasing duration of EVLP, indicating lung perfusion injury.},
  author       = {Pierre, Leif and Lindstedt Ingemansson, Sandra and Hlebowicz, Joanna and Ingemansson, Richard},
  issn         = {1477-111X},
  language     = {eng},
  number       = {4},
  pages        = {322--327},
  publisher    = {SAGE Publications Inc.},
  series       = {Perfusion},
  title        = {Is it possible to further improve the function of pulmonary grafts by extending the duration of lung reconditioning using ex vivo lung perfusion?},
  url          = {http://dx.doi.org/10.1177/0267659113479424},
  volume       = {28},
  year         = {2013},
}