title: Ex vivo lung perfusion in Brazil.
abstract: OBJECTIVE
  To evaluate the use of ex vivo lung perfusion (EVLP) clinically to prepare donor lungs for transplantation.
  
  
  METHODS
  A prospective study involving EVLP for the reconditioning of extended-criteria donor lungs, the criteria for which include aspects such as a PaO2/FiO2 ratio < 300 mmHg. Between February of 2013 and February of 2014, the lungs of five donors were submitted to EVLP for up to 4 h each. During EVLP, respiratory mechanics were continuously evaluated. Once every hour during the procedure, samples of the perfusate were collected and the function of the lungs was evaluated.
  
  
  RESULTS
  The mean PaO2 of the recovered lungs was 262.9 ± 119.7 mmHg at baseline, compared with 357.0 ± 108.5 mmHg after 3 h of EVLP. The mean oxygenation capacity of the lungs improved slightly over the first 3 h of EVLP-246.1 ± 35.1, 257.9 ± 48.9, and 288.8 ± 120.5 mmHg after 1, 2, and 3 h, respectively-without significant differences among the time points (p = 0.508). The mean static compliance was 63.0 ± 18.7 mmHg, 75.6 ± 25.4 mmHg, and 70.4 ± 28.0 mmHg after 1, 2, and 3 h, respectively, with a significant improvement from hour 1 to hour 2 (p = 0.029) but not from hour 2 to hour 3 (p = 0.059). Pulmonary vascular resistance remained stable during EVLP, with no differences among time points (p = 0.284).
  
  
  CONCLUSIONS
  Although the lungs evaluated remained under physiological conditions, the EVLP protocol did not effectively improve lung function, thus precluding transplantation.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Luis Gustavo
authors.initials: LG
authors.lastname: Abdalla
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Karina Andrighetti de Oliveira
authors.initials: KA
authors.lastname: Braga
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Natalia Aparecida
authors.initials: NA
authors.lastname: Nepomuceno
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Lucas Matos
authors.initials: LM
authors.lastname: Fernandes
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Marcos Naoyuki
authors.initials: MN
authors.lastname: Samano
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Paulo Manuel
authors.initials: PM
authors.lastname: Pêgo-Fernandes
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001938:Brazil; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000473:pathology / Q000502:physiology; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D010313:Partial Pressure; D010477:Perfusion / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D018709:Statistics, Nonparametric; D013997:Time Factors; D014019:Tissue Donors; D055815:Young Adult