Lung transplantation from initially rejected donors after ex vivo lung reconditioning: the French experience
OBJECTIVES Only 15% of brain death donors are considered suitable for lung transplantation (LTx). The normothermic ex vivo lung perfusion technique is used to potentially increase the availability of high-risk lung donors. We report our experience of LTx with initially rejected donors after ex vivo...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2014-11, Vol.46 (5), p.794-799 |
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| container_title | European journal of cardio-thoracic surgery |
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| creator | Sage, Edouard Mussot, Sacha Trebbia, Grégoire Puyo, Philippe Stern, Marc Dartevelle, Philippe Chapelier, Alain Fischler, Marc |
| description | OBJECTIVES
Only 15% of brain death donors are considered suitable for lung transplantation (LTx). The normothermic ex vivo lung perfusion technique is used to potentially increase the availability of high-risk lung donors. We report our experience of LTx with initially rejected donors after ex vivo lung reconditioning (EVLR).
METHODS
From April 2011 to May 2013, we performed EVLR for 32 pairs of donor lungs deemed unsuitable for transplantation and rejected by the 11 French lung transplant teams. After EVLR, lungs with acceptable function were transplanted. During the same period, 81 double-lung transplantations (DLTx) were used as controls.
RESULTS
During EVLR, 31 of 32 donor lungs recovered physiological function with a median PO2/FiO2 ratio increasing from 274 (range 162–404) mmHg to 511 (378–668) mmHg at the end of EVLR (P < 0.0001). Thirty-one DLTx were performed. The incidence of primary graft dysfunction 72 h after LTx was 9.5% in the EVLR group and 8.5% in the control group (P = 1). The median time of extubation, intensive care unit and hospital lengths of stay were 1, 9 and 37 days in the EVLR group and 1 (P = 0.17), 6 (P = 0.06) and 28 days (P = 0.09) in the control group, respectively. Thirty-day mortality rates were 3.3% (n = 1) in the EVLR group and 3.7% (n = 3) in the control group (P = 0.69). One-year survival rates were 93% in the EVLR group and 91% in the control group.
CONCLUSIONS
EVLR is a reliable and repeatable technique that offers a significant increase of available donors. The results of LTx with EVLR lungs are similar to those obtained with conventional donors. |
| doi_str_mv | 10.1093/ejcts/ezu245 |
| format | Article |
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Only 15% of brain death donors are considered suitable for lung transplantation (LTx). The normothermic ex vivo lung perfusion technique is used to potentially increase the availability of high-risk lung donors. We report our experience of LTx with initially rejected donors after ex vivo lung reconditioning (EVLR).
METHODS
From April 2011 to May 2013, we performed EVLR for 32 pairs of donor lungs deemed unsuitable for transplantation and rejected by the 11 French lung transplant teams. After EVLR, lungs with acceptable function were transplanted. During the same period, 81 double-lung transplantations (DLTx) were used as controls.
RESULTS
During EVLR, 31 of 32 donor lungs recovered physiological function with a median PO2/FiO2 ratio increasing from 274 (range 162–404) mmHg to 511 (378–668) mmHg at the end of EVLR (P < 0.0001). Thirty-one DLTx were performed. The incidence of primary graft dysfunction 72 h after LTx was 9.5% in the EVLR group and 8.5% in the control group (P = 1). The median time of extubation, intensive care unit and hospital lengths of stay were 1, 9 and 37 days in the EVLR group and 1 (P = 0.17), 6 (P = 0.06) and 28 days (P = 0.09) in the control group, respectively. Thirty-day mortality rates were 3.3% (n = 1) in the EVLR group and 3.7% (n = 3) in the control group (P = 0.69). One-year survival rates were 93% in the EVLR group and 91% in the control group.
CONCLUSIONS
EVLR is a reliable and repeatable technique that offers a significant increase of available donors. The results of LTx with EVLR lungs are similar to those obtained with conventional donors.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezu245</identifier><identifier>PMID: 25061219</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aged ; Female ; France - epidemiology ; Humans ; Lung - physiology ; Lung - surgery ; Lung Transplantation - methods ; Lung Transplantation - mortality ; Lung Transplantation - statistics & numerical data ; Male ; Middle Aged ; Perfusion - methods ; Prospective Studies ; Tissue Donors - statistics & numerical data ; Treatment Outcome ; Young Adult</subject><ispartof>European journal of cardio-thoracic surgery, 2014-11, Vol.46 (5), p.794-799</ispartof><rights>The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2014</rights><rights>The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-d32222714ebfa93a4287660b0f1e6f911081a21a49aee6e976e951d7239695b83</citedby><cites>FETCH-LOGICAL-c427t-d32222714ebfa93a4287660b0f1e6f911081a21a49aee6e976e951d7239695b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25061219$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sage, Edouard</creatorcontrib><creatorcontrib>Mussot, Sacha</creatorcontrib><creatorcontrib>Trebbia, Grégoire</creatorcontrib><creatorcontrib>Puyo, Philippe</creatorcontrib><creatorcontrib>Stern, Marc</creatorcontrib><creatorcontrib>Dartevelle, Philippe</creatorcontrib><creatorcontrib>Chapelier, Alain</creatorcontrib><creatorcontrib>Fischler, Marc</creatorcontrib><creatorcontrib>Foch Lung Transplant Group</creatorcontrib><title>Lung transplantation from initially rejected donors after ex vivo lung reconditioning: the French experience</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>OBJECTIVES
Only 15% of brain death donors are considered suitable for lung transplantation (LTx). The normothermic ex vivo lung perfusion technique is used to potentially increase the availability of high-risk lung donors. We report our experience of LTx with initially rejected donors after ex vivo lung reconditioning (EVLR).
METHODS
From April 2011 to May 2013, we performed EVLR for 32 pairs of donor lungs deemed unsuitable for transplantation and rejected by the 11 French lung transplant teams. After EVLR, lungs with acceptable function were transplanted. During the same period, 81 double-lung transplantations (DLTx) were used as controls.
RESULTS
During EVLR, 31 of 32 donor lungs recovered physiological function with a median PO2/FiO2 ratio increasing from 274 (range 162–404) mmHg to 511 (378–668) mmHg at the end of EVLR (P < 0.0001). Thirty-one DLTx were performed. The incidence of primary graft dysfunction 72 h after LTx was 9.5% in the EVLR group and 8.5% in the control group (P = 1). The median time of extubation, intensive care unit and hospital lengths of stay were 1, 9 and 37 days in the EVLR group and 1 (P = 0.17), 6 (P = 0.06) and 28 days (P = 0.09) in the control group, respectively. Thirty-day mortality rates were 3.3% (n = 1) in the EVLR group and 3.7% (n = 3) in the control group (P = 0.69). One-year survival rates were 93% in the EVLR group and 91% in the control group.
CONCLUSIONS
EVLR is a reliable and repeatable technique that offers a significant increase of available donors. The results of LTx with EVLR lungs are similar to those obtained with conventional donors.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Humans</subject><subject>Lung - physiology</subject><subject>Lung - surgery</subject><subject>Lung Transplantation - methods</subject><subject>Lung Transplantation - mortality</subject><subject>Lung Transplantation - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Perfusion - methods</subject><subject>Prospective Studies</subject><subject>Tissue Donors - statistics & numerical data</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EouVjY0beYCDUdj5cs6GKAlIlFpDYIie5tK4SO9hORfn1uKQwctLpbnjuke5F6IKSW0pEPIF16d0EvnqWpAdoTKc8jnicvB-GnVAScZGQETpxbk0IyWLGj9GIpSSjjIoxaha9XmJvpXZdI7WXXhmNa2tarLTySjbNFltYQ-mhwpXRxjosaw8WwyfeqI3Bzc5goTS6UrtrpZd32K8Azy3ochW4DqwKK5yho1o2Ds738xS9zR9eZ0_R4uXxeXa_iMqEcR9VMQvFaQJFLUUsEzblWUYKUlPIakEpmVLJqEyEBMhA8NAprTiLRSbSYhqfouvB21nz0YPzeatcCU14EEzvcppRwlORpCygNwNaWuOchTrvrGql3eaU5Lt885988yHfgF_uzX3RQvUH_wYagKsBMH33v-obh6-G8A</recordid><startdate>20141101</startdate><enddate>20141101</enddate><creator>Sage, Edouard</creator><creator>Mussot, Sacha</creator><creator>Trebbia, Grégoire</creator><creator>Puyo, Philippe</creator><creator>Stern, Marc</creator><creator>Dartevelle, Philippe</creator><creator>Chapelier, Alain</creator><creator>Fischler, Marc</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141101</creationdate><title>Lung transplantation from initially rejected donors after ex vivo lung reconditioning: the French experience</title><author>Sage, Edouard ; Mussot, Sacha ; Trebbia, Grégoire ; Puyo, Philippe ; Stern, Marc ; Dartevelle, Philippe ; Chapelier, Alain ; Fischler, Marc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c427t-d32222714ebfa93a4287660b0f1e6f911081a21a49aee6e976e951d7239695b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Humans</topic><topic>Lung - physiology</topic><topic>Lung - surgery</topic><topic>Lung Transplantation - methods</topic><topic>Lung Transplantation - mortality</topic><topic>Lung Transplantation - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Perfusion - methods</topic><topic>Prospective Studies</topic><topic>Tissue Donors - statistics & numerical data</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sage, Edouard</creatorcontrib><creatorcontrib>Mussot, Sacha</creatorcontrib><creatorcontrib>Trebbia, Grégoire</creatorcontrib><creatorcontrib>Puyo, Philippe</creatorcontrib><creatorcontrib>Stern, Marc</creatorcontrib><creatorcontrib>Dartevelle, Philippe</creatorcontrib><creatorcontrib>Chapelier, Alain</creatorcontrib><creatorcontrib>Fischler, Marc</creatorcontrib><creatorcontrib>Foch Lung Transplant Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sage, Edouard</au><au>Mussot, Sacha</au><au>Trebbia, Grégoire</au><au>Puyo, Philippe</au><au>Stern, Marc</au><au>Dartevelle, Philippe</au><au>Chapelier, Alain</au><au>Fischler, Marc</au><aucorp>Foch Lung Transplant Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lung transplantation from initially rejected donors after ex vivo lung reconditioning: the French experience</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>46</volume><issue>5</issue><spage>794</spage><epage>799</epage><pages>794-799</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>OBJECTIVES
Only 15% of brain death donors are considered suitable for lung transplantation (LTx). The normothermic ex vivo lung perfusion technique is used to potentially increase the availability of high-risk lung donors. We report our experience of LTx with initially rejected donors after ex vivo lung reconditioning (EVLR).
METHODS
From April 2011 to May 2013, we performed EVLR for 32 pairs of donor lungs deemed unsuitable for transplantation and rejected by the 11 French lung transplant teams. After EVLR, lungs with acceptable function were transplanted. During the same period, 81 double-lung transplantations (DLTx) were used as controls.
RESULTS
During EVLR, 31 of 32 donor lungs recovered physiological function with a median PO2/FiO2 ratio increasing from 274 (range 162–404) mmHg to 511 (378–668) mmHg at the end of EVLR (P < 0.0001). Thirty-one DLTx were performed. The incidence of primary graft dysfunction 72 h after LTx was 9.5% in the EVLR group and 8.5% in the control group (P = 1). The median time of extubation, intensive care unit and hospital lengths of stay were 1, 9 and 37 days in the EVLR group and 1 (P = 0.17), 6 (P = 0.06) and 28 days (P = 0.09) in the control group, respectively. Thirty-day mortality rates were 3.3% (n = 1) in the EVLR group and 3.7% (n = 3) in the control group (P = 0.69). One-year survival rates were 93% in the EVLR group and 91% in the control group.
CONCLUSIONS
EVLR is a reliable and repeatable technique that offers a significant increase of available donors. The results of LTx with EVLR lungs are similar to those obtained with conventional donors.</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>25061219</pmid><doi>10.1093/ejcts/ezu245</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals; MEDLINE; Free E-Journal (出版社公開部分のみ）; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Female France - epidemiology Humans Lung - physiology Lung - surgery Lung Transplantation - methods Lung Transplantation - mortality Lung Transplantation - statistics & numerical data Male Middle Aged Perfusion - methods Prospective Studies Tissue Donors - statistics & numerical data Treatment Outcome Young Adult |
| title | Lung transplantation from initially rejected donors after ex vivo lung reconditioning: the French experience |
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