title: Early effects of the ex vivo evaluation system on graft function after swine lung transplantation.
abstract: OBJECTIVE
  Ex vivo lung evaluation (ex vivo) has been developed as a useful method by which to assess lungs from donation-after-cardiac death (DCD) donors prior to transplant. However, the safety of the ex vivo circulation itself with respect to grafts has not been fully investigated. The aim of this study is to evaluate the effects of the ex vivo circuit using a swine lung transplant model.
  
  
  METHODS
  Lungs with or without 2-h warm ischemia were used. To assess post-transplant graft function, the left lung was transplanted after 2-h ex vivo or cold preservation; blood gas analysis of the left pulmonary vein (partial pressure of oxygen, PO(2)) was performed during the 6-h post-transplant follow-up period. Data were compared between the ex vivo (+) and ex vivo (-) groups.
  
  
  RESULTS
  Partial pressure of oxygen/ inspired oxygen fraction (PO(2)/FiO(2)) in the ex vivo (-) group was significantly greater than that in the ex vivo (+) group until 3h after transplant. The PO(2)/FiO(2) levels in both groups then increased and became similar at 6 h after transplant, regardless of whether ischemic or non-ischemic lungs (p<0.001 and p=0.004, respectively) were used.
  
  
  CONCLUSIONS
  Negative effects of the ex vivo system were limited and seen only in the immediate post-transplant period. Therefore, in DCD swine lung transplantation, the ex vivo system appears to be safe.
authors.affiliation: Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1, Shikata-cho, kita-ku, Okayama 700-8558, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Otani
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oto
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kakishita
authors.forename: Kentaroh
authors.initials: K
authors.lastname: Miyoshi
authors.forename: Shiro
authors.initials: S
authors.lastname: Hori
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamane
authors.forename: Shinichi
authors.initials: S
authors.lastname: Toyooka
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
mesh_terms: D000818:Animals; D003080:Cold Temperature; D046148:Donor Selection / Q000379:methods; D008168:Lung / Q000473:pathology / Q000502:physiology*; D016040:Lung Transplantation / Q000379:methods* / Q000473:pathology / Q000502:physiology; D009926:Organ Preservation / Q000379:methods; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D009195:Peroxidase / Q000378:metabolism; D012129:Respiratory Function Tests / Q000009:adverse effects / Q000379:methods; D034421:Sus scrofa; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods; D052096:Warm Ischemia
chemical_list: D009195:Peroxidase; D010100:Oxygen