First Danish experience with ex vivo lung perfusion of donor lungs before transplantation

Introduction

The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction.

Material and methods

Prospective registration of donor offers and lung transplantations in Denmark 1 May 2012-30 April 2013. Donor lungs without any contraindications were transplanted traditionally. Taken for EVLP were donor lungs otherwise considered transplantable, but without the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test.

Results

Seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes; other recipients were alive with normal graft function. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, corresponding to a 155% improved oxygenation. The median time to extubation, time in ICU and the admission period were 1, 7 and 39 days.

Conclusion

In the first year after the introduction of EVLP in Denmark,
seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs.

Funding

Not relevant.

Trial registration

Not relevant.

CorrespondEnce: Hasse Møller-Sørensen. E-mail: hassedk@gmail.com

Conflicts of interest: Disclosure forms provided by the authors are available with the full text of this article at www.danmedj.dk

Reference: Dan Med J 2014;61(3):A4809