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Perfadex for clinical lung procurement: is it an advance?
Tarek M Aziz1, Thaseegaran M Pillay, Paul A Corris
1Transplant Unit Freeman Hospital, Newcastle-Upon-Tyne, United Kingdom.
The Annals of Thoracic Surgery
|March 21, 2003
Summary
Perfadex did not show superiority over Euro-Collins in clinical lung transplantation outcomes. This study suggests laboratory findings may not translate to real-world lung preservation, necessitating further research.
Area of Science:
- Cardiology
- Transplantation Medicine
- Surgical Innovation
Background:
- Laboratory studies indicated Perfadex (low potassium dextran solution) superiority for lung preservation over Euro-Collins (EC), the clinical standard.
- Clinical evaluation of Perfadex in lung transplantation was warranted to confirm laboratory findings.
Purpose of the Study:
- To evaluate the clinical efficacy of Perfadex lung preservation solution compared to Euro-Collins in lung transplantation.
- To assess Perfadex's impact on graft oxygenation, ventilation duration, ICU stay, and survival.
Main Methods:
- Retrospective analysis of 69 lung allografts.
- Lungs were flushed with either Euro-Collins (37 patients) or Perfadex (32 patients).
- Outcomes measured included chest roentgenogram scores, oxygenation, mechanical ventilation duration, ICU stay, and survival.
Main Results:
- No significant differences were observed in chest roentgenogram scores, arterial alveolar oxygen tension ratio, ventilation time, or intensive care unit stay between the Perfadex and EC groups.
- Graft oxygenation and survival rates due to primary organ failure were comparable between the two preservation solutions.
- The Perfadex group showed a slightly lower, though not statistically significant, rate of death from primary organ failure (3.1% vs. 5.1%).
Conclusions:
- Perfadex demonstrated no significant clinical advantage over Euro-Collins for lung preservation in this study.
- Discrepancies between laboratory results and clinical outcomes may be attributed to the complexities of brain death lung injury in real-world scenarios.
- Further investigation is needed to determine Perfadex's long-term impact on lung transplant outcomes.