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New Technique Keeps Donor Lungs Viable Longer: Study

FRIDAY, Nov. 18, 2016 -- A technique that allows lungs destined for transplants to be preserved longer works well, a new Canadian study finds. The strategy, called ex-vivo lung perfusion (EVLP), allows preservation of lungs for up to 12 hours,...
Source: Drugs.com - Daily MedNews - Category: Journals (General) Source Type: news

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This article summarizes recent knowledge and clinical advances in machine perfusion (MP) of thoracic organs. MP of thoracic organs has gained much attention during the last decade. Clinical studies are investigating the role of MP to preserve, resuscitate, and assess heart and lungs prior to transplantation. Currently, MP of the cardiac allograft is essential in all type DCD heart transplantation while MP of the pulmonary allograft is mandatory in uncontrolled DCD lung transplantation. MP of thoracic organs also offers an exciting platform to further investigate downregulation of the innate and adaptive immunity prior to r...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
In this study, we obtained two decellularized rat lung scaffolds using a novel detergent sodium lauryl ether sulfate (SLES) and a conventional detergent sodium dodecyl sulfate (SDS). Both decellularized lung scaffolds were assessed by histology, immunohistochemistry, scanning electron microscopy, DNA quantification, sulfated glycosaminoglycans (GAGs) quantification and western blot. Subsequently, the scaffolds were implanted subcutaneously in rats for 6 weeks and were evaluated via hematoxylin and eosin staining and Masson staining. Results indicated that SLES was effective to remove cells; moreover, lungs decellularized w...
Source: ASAIO Journal - Category: Medical Devices Tags: Tissue Engineering/Biomaterials Source Type: research
Authors: Rodríguez-Roisin R, Krowka MJ, Agustí A Abstract This review concentrates on the determinants of gas exchange abnormalities in liver-induced pulmonary vascular disorders, more specifically in the hepatopulmonary syndrome. Increased alveolar-arterial O2 difference, with or without different levels of arterial hypoxemia, and reduced diffusing capacity represent the most characteristic gas exchange disturbances in the absence of cardiac and pulmonary comorbidities. Pulmonary gas exchange abnormalities in the hepatopulmonary syndrome are unique encompassing all three pulmonary factors determining...
Source: Comprehensive Physiology - Category: Physiology Tags: Compr Physiol Source Type: research
TransMedics said today that it won pre-market approval from the FDA for its OCD Lung transplant system, which is designed to keep donated human lungs in near-living condition until transplantation. The March 22 approval covers standard double-lung transplantation procedures, Andover, Mass.-based TransMedics said. The federal safety watchdog granted the PMA based on data from the 316-patient Inspire trial, the results from which were published this week in The Lancet Respiratory Medicine, comparing OCS lung with the standard of care – cold flush and storage. Inspire met its primary outcome – a composite of ...
Source: Mass Device - Category: Medical Devices Authors: Tags: Clinical Trials Regulatory/Compliance Respiratory Transplants Wall Street Beat transmedics Source Type: news
CONCLUSION: The literature strongly supports a specific infusion rate1-7 (2.5 mg/kg/h) for bivalirudin anticoagulation during extracorporeal circulation. Clinicians must consider the loss of clotting factors and the administration of blood products while adjusting the bivalirudin infusion during bypass. We have now elected to maintain an infusion rate of ≥0.5 mg/kg/h for bivalirudin anticoagulation at our center, based on institutional experience, though consideration for a higher infusion rate for an added margin of safety should be considered. It is imperative to have a well-developed protocol for the management of th...
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Adult heart transplantation from Donation After Circulatory Determined Death (DCD) donors is now established in four heart transplant centers across the globe. The protocols for acceptable donation withdrawal ischaemia time, DWIT (period from withdrawal of life supportive therapy (WLST) to onset of heart perfusion) vary from 30 minutes to 4 hours. If the 30-minute guideline is adhered to many donors will not meet criteria within this short ischaemic period, resulting in the loss of some donor hearts that may have been acceptable for transplantation.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Standard heart preservation, before transplantation, consists of cold ischemic storage of the heart. Clinical studies have shown that the morbidity and mortality risk increases with an extension of the allograft ischemic time. Pre-clinical studies have demonstrated that a new preservation technology of donor hearts, using an ex-vivo non-ischemic heart perfusion system (NIHP), can be safely applied 24 hours in pigs. However, until now this state-of-the-art technique has never been used on humans.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
The clinical use of ex vivo lung perfusion (EVLP) allows for the assessment of donor lung viability prior to transplantation, and has helped to expand the donor pool. The EVLP perfusate offers a unique opportunity to assess biological processes in the donor lung. Neutrophil extracellular traps (NETs) have been described as a product of NETosis, an innate neutrophil-mediated immune response. NETs have been implicated in acute lung injury and have been shown to be pathogenic in primary graft dysfunction.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Neurological complications are the major causes of death in patients on ECMO. Near-infrared spectroscopy (NIRS) is used as a noninvasive method of surveillance for cerebral perfusion. Cerebral oxygen saturation monitoring by NIRS may predict neurological injury in ECMO patients
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Regulatory T cells (Tregs) can be expanded and cryopreserved, making them a viable therapeutic option in lung transplantation (LTx). Tregs may potently control alloreactive conventional T cells (Tcon) if they interact with antigen-presenting cells (APCs) prior to, rather than with, Tcon. Normothermic ex vivo lung perfusion (EVLP) provides the opportunity for graft therapy prior to LTx. We aimed to determine feasibility, engraftment potential and effects of recipient-derived Tregs delivered during EVLP.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
More News: General Medicine | Lung Transplant | Perfusion | Study | Transplants