title: First Danish experience with ex vivo lung perfusion of donor lungs before transplantation.
abstract: BACKGROUND
  The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction.
  
  
  METHODS
  The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test.
  
  
  RESULTS
  In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively.
  
  
  CONCLUSIONS
  In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs.
  
  
  BACKGROUND
  no funding was granted for the present paper.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Anæstesiafdelingen, Hjertecentret, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. hassedk@gmail.com.
authors.forename: Ian Sune Iversen
authors.initials: IS
authors.lastname: Henriksen
authors.forename: Hasse
authors.initials: H
authors.lastname: Møller-Sørensen
authors.forename: Christian Holdfold
authors.initials: CH
authors.lastname: Møller
authors.forename: Mikhail
authors.initials: M
authors.lastname: Zemtsovski
authors.forename: Jens Christian
authors.initials: JC
authors.lastname: Nilsson
authors.forename: Casper Tobias
authors.initials: CT
authors.lastname: Seidelin
authors.forename: Michael
authors.initials: M
authors.lastname: Perch
authors.forename: Martin
authors.initials: M
authors.lastname: Iversen
authors.forename: Daniel
authors.initials: D
authors.lastname: Steinbrüchel
mesh_terms: D003718:Denmark; D046148:Donor Selection; D006801:Humans; D008168:Lung / Q000098:blood supply*; D016040:Lung Transplantation / Q000379:methods; D010477:Perfusion / Q000379:methods; D011300:Preoperative Care; D014019:Tissue Donors / Q000600:supply & distribution