Extended post-ex vivo lung perfusion cold preservation predicts primary graft dysfunction and mortality: Results from a multicentric study

Ex vivo lung perfusion (EVLP) allows for a reassessment of lung grafts initially deemed unsuitable for transplantation, increasing the available donor pool; however, this requires a pre- and post-EVLP period of cold ischemic time (CIT). Paucity of data exists on how the sequence of cold normothermic –cold preservations affect outcomes.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: ORIGINAL CLINICAL SCIENCE Source Type: research

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Abstract Rescuing patients with the development of acute respiratory distress syndrome and right heart failure after left ventricular assist device placement remains a challenge in patients with congenital heart disease. TandemLife Protek Duo (TandemLife, Pittsburg, PA) is a double-lumen cannula introduced via the internal jugular vein that can provide veno-venous extra-corporeal membrane oxygenation and right heart support. To our knowledge, we report the first case of successfully using the TandemLife Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricle support in an...
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
EVLP allows for reassessment of lung grafts initially deemed unsuitable for transplantation, increasing the available donor pool, however this requires a pre and post-EVLP period of cold ischemic time (CIT). Paucity of data exist on how the sequence of cold-normothermic-cold preservations affect outcomes.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
Organ transplantation is undergoing profound changes. Contraindications for donation have been revised in order to better meet the organ demand. The use of lower-quality organs and organs with greater preoperative damage, including those from donation after cardiac death (DCD), has become an established routine but increases the risk of graft malfunction. This risk is further aggravated by ischemia and reperfusion injury (IRI) in the process of transplantation. These circumstances demand a preservation technology that ameliorates IRI and allows for assessment of viability and function prior to transplantation. Oxygenated h...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
We read with great interest the manuscript of Kobayashi J. et al. recently published in the Journal of Heart and Lung Transplantation.(1) The authors investigated the relevance of flow-targeted ex vivo heart perfusion (EVHP) in a porcine model of donation after circulatory death. They concluded that controlled flow-targeted myocardial perfusion was associated with better myocardial performance than pressure-targeted strategy. Their hemodynamic results are particularly derived from pressure-volume (PV) analysis.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
Abstract Diffuse alveolar hemorrhage after percutaneous coronary intervention is a rare but fatal complication. Although timely application of extracorporeal membrane oxygenator and discontinuation of antiplatelet/anticoagulation is the treatment of choice, bleeding is often irreversible. Herein, we introduce a patient with refractory diffuse alveolar hemorrhage after prolonged extracorporeal membrane oxygenator and percutaneous coronary intervention, who was eventually rescued with heart-lung transplantation. PMID: 32308141 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
This article summarises the main types of mechanical circulatory support and how they work, particularly focusing on the key information medical professionals should know should they encounter them in hospital. Mechanical circulatory support can be an effective treatment modality in selected pathologies, including myocardial ischaemia, pulmonary congestion, massive pulmonary embolic disease, postcardiotomy cardiogenic shock with failure to wean off bypass, right ventricular failure, bridge to heart and lung transplant and, increasingly, extracorporeal cardiopulmonary resuscitation. Intra-aortic balloon pumps increase coron...
Source: British Journal of Hospital Medicine - Category: Internal Medicine Authors: Tags: Br J Hosp Med (Lond) Source Type: research
We describe the case of combined cardiogenic and distributive shock due to necrotizing pulmonary blastomycosis. After initial central VA-ECMO cannulation, acute respiratory distress syndrome (ARDS) with increasing shunt resulted in significant central hypoxemia due to progressive ventilation-perfusion mismatch. An additional circuit provided complete oxygenation of the high circulating volume. After 4 months on support, he underwent successful heart-lung-kidney transplantation. Dual ECMO circuits are technically feasible and may be advantageous in specific circumstances of high pulmonary shunting resulting in excessive hyp...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Report Source Type: research
Donation after cardiac death (DCD) donor lungs have been shown to be less pro-inflammatory than donation after brain death (DBD) lungs, likely due to the absence of brain-death related inflammatory physiology. However, it is unclear whether this difference is clinically significant following reperfusion either by EVLP or transplantation. We sought to examine the effect of EVLP on gene expression in DCD and DBD lungs.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (25) Source Type: research
Significant advantages are associated with inhaled therapies for pulmonary arterial hypertension (PAH), including enhanced delivery of drug to the lungs at a lower overall dose, improved ventilation-perfusion matching, and decreased risk of systemic vasodilation and other systemic adverse effects. LIQ861 is an investigational, novel, dry-powder formulation of treprostinil (TRE) designed using PRINT ® technology to enhance deep-lung drug deposition and enable delivery of TRE doses in 1 to 2 breaths per capsule 4 times per day while using a convenient dry-powder inhaler.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (14) Source Type: research
Ex-vivo lung perfusion (EVLP) maintains marginal donor lungs at body temperature with ventilation and circulating perfusate, allowing for functional assessment prior to transplantation. Prolonged EVLP would allow for advanced time-dependent therapies for donor lung repair and reconditioning. We hypothesized that the addition of a dialysis machine to the EVLP circuit would maintain homeostasis of the donor lung and prolong EVLP duration.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (343) Source Type: research
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