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Prolonged EVLP Using OCS Lung: Cellular and Acellular Perfusates.

Gabriel Loor1, Brian T Howard, John R Spratt

  • 11 Department of Surgery, University of Minnesota, Minneapolis, MN. 2 Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN. 3 Department of Pediatrics, University of Minnesota, Minneapolis, MN. 4 Masonic Cancer Center, University of Minnesota, Minneapolis, MN. 5 Department of Biostatisitics, University of Minnesota, Minneapolis, MN. 6 Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN. 7 Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN.

Transplantation
|December 24, 2016
PubMed
Summary
This summary is machine-generated.

Using autologous whole donor blood in ex vivo lung perfusion (EVLP) successfully extended lung preservation to 24 hours. This whole blood perfusate demonstrated superior stability compared to red blood cells for donor lung reconditioning.

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Area of Science:

  • Transplantation Science
  • Organ Preservation
  • Ex Vivo Perfusion Technology

Background:

  • Extending donor lung preservation time is critical for improving transplant outcomes.
  • Current ex vivo lung perfusion (EVLP) methods face limitations in duration and efficacy.
  • Normothermic EVLP using autologous whole blood is explored for enhanced lung reconditioning.

Purpose of the Study:

  • To evaluate the efficacy of autologous whole donor blood in extending lung preservation time using EVLP.
  • To compare the performance of whole blood perfusate against red blood cells and acellular solutions.
  • To assess the potential of EVLP with whole blood for donor lung reconditioning.

Main Methods:

  • Twelve pairs of swine lungs were preserved for 24 hours on the Organ Care System (OCS) Lung EVLP platform.
  • Lungs were perfused with three types of solutions: isolated red blood cells (RBCs), whole blood (WB), and an acellular dextran-albumin solution.
  • Comparative analysis focused on physiological parameters and graft function over the 24-hour preservation period.

Main Results:

  • Whole blood (WB) perfusate maintained superior stability of monitored parameters compared to isolated red blood cells (RBCs) over 24 hours.
  • Key indicators like pulmonary artery pressure and PaO2:FiO2 ratio showed better outcomes with WB.
  • Acellular perfusion was limited to 6 hours due to high vascular resistance and edema, failing to meet clinical standards.

Conclusions:

  • Autologous whole donor blood enables 24-hour lung preservation without functional decline in a swine EVLP model.
  • Whole blood perfusate significantly outperformed RBC and acellular solutions for extended lung preservation.
  • This approach represents a promising advancement for donor lung preservation and reconditioning, potentially improving transplant success rates.