Donor lungs with pulmonary embolism evaluated with ex vivo lung perfusion

ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Chase R BrownDavid P Mason

Abstract

Acute pulmonary embolism (PE) compromises oxygenation and is typically considered a contraindication to lung donation for transplantation. We report the use of ex vivo lung perfusion (EVLP) to evaluate and possibly improve a pair of donor lungs with PE and poor oxygen exchange to a condition that might have been suitable for subsequent transplantation. A pair of donor lungs was procured for research after being declined for clinical use and placed on the EVLP circuit for 7 hours. Functional monitoring of the lungs revealed an increase in the partial pressure of oxygen to fraction of inspired oxygen ratio (P/F ratio) from 268 in situ to 458 after EVLP. While on the circuit, pulmonary vascular resistance decreased as dynamic compliance of the lungs increased, suggesting they might have been acceptable for transplantation.

References

Apr 13, 2007·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J D PunchM S Seely
Jan 12, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Takahiro OtoGregory I Snell
Dec 9, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Marcelo CypelShaf Keshavjee
Dec 23, 2008·The Annals of Thoracic Surgery·Richard IngemanssonStig Steen
Dec 15, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Basar SareyyupogluYoshiya Toyoda
Apr 15, 2011·The New England Journal of Medicine·Marcelo CypelShaf Keshavjee

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