%0 Journal Article
%T Effects of immediate versus delayed ex
%A Achim Koch
%A Carolin Olbertz
%A Clemens Aigner
%A Hagen B£¿umker
%A Ingo Nolte
%A Markus Kamler
%A Nikolaus Pizanis
%A Simon Becker
%A Ursula Rauen
%J The International Journal of Artificial Organs
%@ 1724-6040
%D 2019
%R 10.1177/0391398819841618
%X Ex-vivo lung perfusion is a promising tool to evaluate and recondition marginal donor lungs usually after a cold static preservation. The concept of continuous organ perfusion is supposed to reduce ischemic damage; however, the optimal perfusion protocol has not been established yet. The aim of this study was to compare immediate ex-vivo lung perfusion (I-EVLP) to delayed ex-vivo lung perfusion (D-EVLP) after a certain cold static preservation period on lung function in a large animal model. In a porcine model, lungs were procured after circulatory death and 60£¿min of no-touch warm ischemia. Lungs were preserved with single-flush cold low potassium dextran solution and prepared either for I-EVLP (n£¿=£¿8) or stored cold for 9 h with subsequent D-EVLP (n£¿=£¿8). Functional outcomes and morphology were compared during 4 h of ex-vivo lung perfusion, using STEEN SolutionTM as perfusion solution. Pulmonary functional data, perfusate activities of lactate dehydrogenase, alkaline phosphatase, and products of lipid peroxidation did not differ significantly. There was a trend toward lower wet¨Cdry ratio (I-EVLP: 13.4£¿¡À£¿2.9; D-EVLP: 9.1£¿¡À£¿2.5) and higher ¦¤pO2 in D-EVLP group (I-EVLP: 209£¿¡À£¿51.6£¿mmHg; D-EVLP: 236.3£¿¡À£¿47.3£¿mmHg). In this donation-after-circulatory-death model, 9 h of cold static preservation followed by ex-vivo lung perfusion results in comparable pulmonary function to I-EVLP as indicated by oxygenation capacities and wet¨Cdry ratio. Our findings indicate that prolonged cold static preservation prior to ex-vivo lung perfusion is as safe and effective as I-EVLP in the procurement of donor lungs
%K Marginal donor lungs
%K lung transplantation
%K organ preservation
%K cold static preservation
%K ex-vivo lung perfusion
%U https://journals.sagepub.com/doi/full/10.1177/0391398819841618