title: Clinical Outcome of Patients Transplanted with Marginal Donor Lungs via Ex Vivo Lung Perfusion Compared to Standard Lung Transplantation.
abstract: BACKGROUND
  Lung transplantation is limited by a scarcity of suitable donors resulting in high waiting list mortality. Ex vivo lung perfusion (EVLP) allows the evaluation and reconditioning of marginal donor lungs for use in transplantation. This study aimed to compare clinical outcome of patients transplanted with marginal organs by means of EVLP with a standard lung transplant cohort through a multicenter open trial.
  
  
  METHODS
  Group 1 (n = 9) included patients transplanted using EVLP reconditioned marginal lungs. Group 2 (n = 46) consisted of date-matched patients transplanted using standard transplantation of acceptable lungs. The primary composite endpoint included acute rejection and infection at 12 months after transplantation.
  
  
  RESULTS
  There was no significant difference in the overall incidence of acute rejection (P = 0.754) and the number of treated infection episodes (proven/probable pneumonia; P = 0.857/0.368 and proven/probable tracheobronchitis; P = 0.226/0.529) up to 12 months after transplantation, between group 1 and group 2. Additionally, there was no significant difference in early clinical outcome, including intensive care unit stay, hospital stay, and 1 year mortality between the two groups (P = 0.338, P = 0.112 and P = 0.372, respectively).
  
  
  CONCLUSIONS
  This multicenter study demonstrates that EVLP is associated with no adverse effect on clinical outcome, including the incidence of acute rejection and infection after lung transplantation.
authors.affiliation: 1 The Transplant Centre, University Hospital of South Manchester, Manchester, United Kingdom. 2 The Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, United Kingdom. 3 Department of Cardiothoracic Surgery, Lund University Hospital, Sweden.
authors.forename: James E
authors.initials: JE
authors.lastname: Fildes
authors.forename: Louise D
authors.initials: LD
authors.lastname: Archer
authors.forename: John
authors.initials: J
authors.lastname: Blaikley
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Ball
authors.forename: John P
authors.initials: JP
authors.lastname: Stone
authors.forename: Trygve
authors.initials: T
authors.lastname: Sjöberg
authors.forename: Stig
authors.initials: S
authors.lastname: Steen
authors.forename: Nizar
authors.initials: N
authors.lastname: Yonan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D008168:Lung / Q000098:blood supply*; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D014019:Tissue Donors