Original clinical scienceEffect of donor preservation solution and survival in lung transplantation
Section snippets
Methods
A retrospective review was conducted of prospectively collected data on 310 patients who underwent single- or double-lung transplantation at our institution between January 2000 and December 2007. Data on donor and recipient demographic variables, donor preservation strategy and outcomes were collected. The main outcomes analyzed were all-cause mortality, and PGD at 0, 12, 24 and 48 hours. Donor and recipient demographics are presented in Table 1.
The strategies of recipient selection, donor
Results
Three hundred ten lung transplants (216 double-lung transplants and 94 single-lung transplants) were performed over the 8-year period. Data on preservation solution used in 3 transplants were missing and these patients were excluded from analysis. Heart–lung transplants were also excluded from consideration in this study. The groups had notable differences in some of the variables. The Perfadex and Euro-Collins groups are not historically comparable and this is reflected in the more recent
Discussion
The present results show that the use of Papworth solution for donor lung preservation is associated with significantly increased mortality and an increased risk of severe PGD compared with both Euro-Collins and Perfadex preservation solutions. To our knowledge, there have been no published findings describing the association between Papworth solution and poorer survival in humans after lung transplantation.
Concerns with Papworth solution include the fact that it is made up at the bedside,
Disclosure statement
The authors thank Anne Griffiths and Bronwyn Levvey for their assistance with data collection.
The authors have no conflicts of interest to disclose.
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Cited by (30)
Chinese expert consensus on organ protection of transplantation (2022 edition)
2022, Hepatobiliary and Pancreatic Diseases InternationalNormothermic ex-vivo preservation with the portable Organ Care System Lung device for bilateral lung transplantation (INSPIRE): a randomised, open-label, non-inferiority, phase 3 study
2018, The Lancet Respiratory MedicineCitation Excerpt :Over the past three decades, lung transplantation has seen substantial advancements, but donor lung preservation has remained limited to cold static storage.1–4 Cold storage is reasonably successful provided donor lung quality is high and ischaemia times are not excessive.1 However, static cold storage has limitations; it subjects the donor lungs to ischaemia–reperfusion injury and provides no resuscitative or assessment capabilities during the preservation period.
Comparison between cellular and acellular perfusates for ex vivo lung perfusion in a porcine model
2015, Journal of Heart and Lung TransplantationCitation Excerpt :The 8-mm endotracheal tube was connected to the ventilator. The circuit for group 1 was primed with 2 liters STEEN, the circuit for group 2 was primed with 1.5 liters STEEN solution and 2 to 3 U leukocyte-depleted blood, and the circuit for group 3 was primed with 1 liter Hartmann’s solution, 300 ml human albumin solution 20%, 150 ml mannitol 20%, 100 ml citrate-phosphate buffer, and 2 to 3 U leukocyte-depleted blood (Papworth-Blood solution).16 The pH was normalized in all groups.
CASE 8 2014 Anesthetic management of bilateral lung transplantation from donor lungs managed by the organ care system
2014, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Although many studies have been performed investigating optimization of donor lung preservation in order to minimize ischemic injury, no major breakthroughs have been made.3,9–13 Traditionally, hypothermic flush and storage has been accepted as the standard preservation technique for donor lungs intended for transplantation.18 With the concept of living organ transplant (ie, breathing lungs), Transmedics has developed a portable, ex-vivo, normothermic perfusion system that allows the donor lungs to function and “breathe” in a near-physiologic state outside the body during transport, thus minimizing ischemic time.
Current Status of Lung Transplantation
2014, Regenerative Medicine Applications in Organ Transplantation