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Long-term Outcomes of Lung Transplant With Ex Vivo Lung Perfusion

Divithotawela C, Cypel M, Martinu T, Singer LG, Binnie M, Chow CW, Chaparro C, Waddell TK, de Perrot M, Pierre A, Yasufuku K, Yeung JC, Donahoe L, Keshavjee S and Tikkanen JM.

This single-center, observational study presents the long-term outcomes of transplant recipients of donor lungs treated with ex vivo lung perfusion (EVLP). Of the 936 lung transplants performed during the study period, 230 (25%) were treated with EVLP; the remaining 706 (75%) that did not undergo EVLP were used as a control. Despite donor lungs treated with EVLP had significantly lower PaO2 at the time of assessment and multiple other risk factors, both short-term and long-term outcomes were similar to standard donor lungs. Estimated graft survival between the EVLP-treated lungs and non-EVLP lungs was 73% vs 72% at 3 years; 62% vs 58% at 5 years; and 50% vs 44% at 9 years. Also, chronic lung allograft dysfunction (CLAD)-free graft survival for the EVLP and non-EVLP groups were 70% vs 72% at 3 years, 56% vs 56% at 5 years, and 53% vs 36% at 9 years. In the EVLP group, fewer patients suffered moderate to severe primary graft dysfunction (PGD 2 and 3) at 72 hours (22% vs 29%; OR 0.68), and spent fewer days in hospital (22 days vs 25 days; p=0.008) compared with the non-EVLP group. The authors conclude that EVLP has enabled them to significantly and safely increase their lung transplant activity to offer lung transplantation to more individuals in need of this life-saving therapy.

“This study confirms the similar long-term outcomes of EVLP-treated high-risk extended criteria donor lungs compared with conventional donor lungs”

Divithotawela et al 2019


JAMA Surg  / 2019 / doi: 10.1001/jamasurg.2019.4079


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