title: Normothermic ex vivo lung perfusion of non-heart-beating donor lungs in pigs: from pretransplant function analysis towards a 6-h machine preservation.
abstract: Donor shortage urges optimal use of all lungs available. Ex vivo lung perfusion (EVLP) is a method to evaluate lung function before implantation. EVLP was performed in pigs to evaluate lung function, using two different clinical non-heart-beating (NHS) donor protocols: flush perfusion and topical cooling after 1-h warm ischaemia (n = 5 each). Secondly, we investigated whether EVLP can be used for 6 h ex vivo machine preservation (n = 4). In comparison with topical cooling, flush perfusion preserved lung function better during EVLP. During 6 h normothermic EVLP, gas exchange remained stable; however, the pulmonary artery pressure and ventilation pressure showed a significant increase. EVLP is a reliable method for evaluation of lung graft function. Flush perfusion with Perfadex is preferred above topical cooling in NHB lung donation. Six-hour normothermic EVLP is feasible but should be further improved to make ex vivo machine preservation or treatment of lung grafts successful.
authors.affiliation: Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. m.e.erasmus@thorax.umcg.nl
authors.forename: Michiel E
authors.initials: ME
authors.lastname: Erasmus
authors.forename: Meine H
authors.initials: MH
authors.lastname: Fernhout
authors.forename: Jan M
authors.initials: JM
authors.lastname: Elstrodt
authors.forename: Gerhard
authors.initials: G
authors.lastname: Rakhorst
mesh_terms: D000818:Animals; D005260:Female; D007511:Ischemia; D019194:Ischemic Preconditioning; D008168:Lung / Q000473:pathology*; D016040:Lung Transplantation / Q000379:methods*; D019188:Organ Preservation Solutions; D010477:Perfusion; D011309:Preservation, Biological; D013552:Swine; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods*
chemical_list: D019188:Organ Preservation Solutions