title: Ex Vivo Lung Perfusion: Establishment and Operationalization in Iran.
abstract: OBJECTIVE
  Although the number of lung transplants is limited because of general shortage of organ donors, ex vivo lung perfusion is a novel method with 2 main benefits, including better evaluation of lung potential and recovery of injured lungs. The main aim of this study was to establish and operationalize ex vivo lung perfusion as the first experience in Iran.
  
  
  METHODS
  This was a prospective operational research study on 5 cases, including 1 pig from Vienna Medical University and 4 patients from Masih Daneshvari Hospital. All organ donations from brain dead donors were evaluated according to lung transplant or ex vivo lung perfusion criteria from May 2013 to July 2015 in Tehran, Iran. If a donor did not have any sign of severe chest trauma or pneumonia but had poor oxygenation due to possible atelectasis or neurogenic pulmonary edema, their lungs were included for ex vivo lung perfusion.
  
  
  RESULTS
  A successful trend in the difference between the pulmonary arterial Po2 and the left atrial Po2 was observed, as well as an increasing pattern in other functional parameters, including dynamic lung compliance and a decreasing trend in pulmonary vascular resistance.
  
  
  CONCLUSIONS
  These initial trials indicate that ex vivo lung perfusion can lead to remarkable progress in lung transplant in Iran. They also provide several important pieces of guidance for successful ex vivo lung perfusion, including the necessity of following standard lung retrieval procedures and monitoring temperature and pressure precisely. The development of novel methods can provide opportunities for further research studies on lungs of deceased donors and lead to undiscovered findings. By keeping this science up to date in Iran and developing such new and creative methods, we can reveal effective strategies to promote the quality of donor lungs to support patients on transplant wait lists.
authors.affiliation: From the Lung Transplant Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Shadi
authors.initials: S
authors.lastname: Shafaghi
authors.forename: Azizollah
authors.initials: A
authors.lastname: Abbasi Dezfuli
authors.forename: Zahra
authors.initials: Z
authors.lastname: Ansari Aval
authors.forename: Kambiz
authors.initials: K
authors.lastname: Sheikhy
authors.forename: Behrooz
authors.initials: B
authors.lastname: Farzanegan
authors.forename: Esmaeil
authors.initials: E
authors.lastname: Mortaz
authors.forename: Habib
authors.initials: H
authors.lastname: Emami
authors.forename: Clemens
authors.initials: C
authors.lastname: Aigner
authors.forename: Fatemeh Sadat
authors.initials: FS
authors.lastname: Hosseini-Baharanchi
authors.forename: Katayoun
authors.initials: K
authors.lastname: Najafizadeh
mesh_terms: D000818:Animals; D062186:Arterial Pressure; D046148:Donor Selection; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D023421:Models, Animal; D009926:Organ Preservation / Q000009:adverse effects / Q000379:methods*; D010477:Perfusion / Q000009:adverse effects; D015397:Program Evaluation; D011446:Prospective Studies; D011652:Pulmonary Circulation; D012119:Respiration; D012129:Respiratory Function Tests; D034421:Sus scrofa; D013696:Temperature; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D014655:Vascular Resistance