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

Transpl Int. 2019 Feb;32(2):131-140. doi: 10.1111/tri.13365. Epub 2018 Nov 13.

Abstract

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™ 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™ 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 /FiO2 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™ Lung; a prospective trial is underway to validate its role to safely increase the number of donor lungs.

Keywords: OCS lung; extended criteria donors; ex vivo lung perfusion; reconditioning.

MeSH terms

  • Adolescent
  • Adult
  • Critical Care
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Ischemia / pathology
  • Length of Stay
  • Lung Diseases / surgery*
  • Lung Transplantation / methods*
  • Male
  • Middle Aged
  • Organ Preservation
  • Perfusion
  • Postoperative Period
  • Primary Graft Dysfunction / diagnosis
  • Respiration, Artificial
  • Time Factors
  • Tissue Donors
  • Tissue and Organ Procurement / standards
  • Treatment Outcome