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Published on: August 13, 2014
Extended ischemic time (>15 hours) using controlled hypothermic storage in lung transplantation: A multicenter
Rene Novysedlak1, An-Lies Provoost2, Nathaniel B Langer3
1Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium; Prague Lung Transplant Program, 3rd Department of Surgery, First Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic; Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery, BREATHE, KU Leuven, Leuven, Belgium.
Controlled hypothermic storage (CHS) safely extends lung preservation beyond 15 hours, overcoming limitations of static ice storage. This multicenter study shows CHS is feasible for lung transplantation (LuTx) with extended ischemic times.
Area of Science:
- Cardiology and Thoracic Surgery
- Organ Transplantation
- Preservation Medicine
Background:
- Static ice storage is the standard for lung preservation but is limited by freezing injury, restricting ischemic time (IT).
- Controlled hypothermic storage (CHS) at a higher temperature may offer a safer alternative to extend IT.
Purpose of the Study:
- To assess the feasibility and safety of CHS for lung preservation with IT exceeding 15 hours.
- To evaluate short-term outcomes of lung transplant recipients (LuTx) utilizing CHS.
Main Methods:
- A retrospective analysis of 13 LuTx recipients across three centers from April to October 2023.
- Donor lungs were preserved using a portable CHS device at 7°C (range 5-9.3°C).
- Data collected included demographics, storage details, IT, and short-term post-LuTx outcomes.
Main Results:
- The IT for the second-implanted lung averaged 17.3 hours (range 15.1-22 hours).
- All LuTx were successful; 4/13 patients experienced primary graft dysfunction (PGD) grade 3 within 72 hours.
- Post-LuTx ventilation averaged 29 hours, ICU stay 9 days, and hospital stay 30 days. Four patients required extracorporeal membrane oxygenation (ECMO).
Conclusions:
- This multicenter experience demonstrates the feasibility of safely extending lung ischemic time beyond 15 hours using CHS.
- CHS represents a promising strategy for lung preservation, particularly for bridging or long-distance transport in lung transplantation.
