Portable normothermic ex-vivo lung perfusion, ventilation, and functional assessment with the Organ Care System on donor lung use for transplantation from extended-criteria donors (EXPAND): a single-arm, pivotal trial

Publication date: Available online 1 August 2019Source: The Lancet Respiratory MedicineAuthor(s): Gabriel Loor, Gregor Warnecke, Mauricio A Villavicencio, Michael A Smith, Jasleen Kukreja, Abbas Ardehali, Matthew Hartwig, Mani A Daneshmand, Marshall I Hertz, Stephen Huddleston, Axel Haverich, Joren C Madsen, Dirk Van RaemdonckSummaryBackgroundDonor lung use for transplantation is the lowest among solid organ tranplants because of several complex and multifactorial reasons; one area that could have a substantial role is the limited capabilities of cold ischaemic storage. The aim of the EXPAND trial was to evaluate the efficacy of normothermic portable Organ Care System (OCS) Lung perfusion and ventilation on donor lung use from extended-criteria donors and donors after circulatory death, which are rarely used.MethodsIn this single-arm, pivotal trial done in eight institutions across the USA, Germany, and Belgium, lungs from extended-criteria donors were included if fulfilling one or more of the following criteria: a ratio of partial pressure of arterial oxygen (PaO2) to fractional concentration of oxygen inspired air (FiO2) in the donor lung of 300 mm Hg or less; expected ischaemic time longer than 6 h; donor age 55 years or older; or lungs from donors after circulatory death that were recruited and assessed using OCS Lung. Lungs were transplanted if they showed stability of OCS Lung variables, PaO2:FiO2 was more than 300 mm Hg, and they were accepted by the transplanting surg...
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research