| Ex vivo lung perfusion: early report of Brazilian experience. | |
| | |
MedLine Citation:
|
PMID: 20304159 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Only about 15% of the potential candidates for lung donation are considered suitable for transplantation. A new method for ex vivo lung perfusion (EVLP) can be used to evaluate and recondition "marginal," nonacceptable lungs. We have herein described an initial experience with ex vivo perfusion of 8 donor lungs deemed nonacceptable. MATERIALS AND METHODS: After harvesting, the lungs were perfused ex vivo with Steen Solution, an extracellular matrix with high colloid osmotic pressure. A membrane oxygenator connected to the circuit received gas from a mixture of nitrogen and carbon dioxide, maintaining a normal mixed venous blood gas level in the perfusate. The lungs were gradually rewarmed, reperfused, and ventilated for evaluation through analyses of oxygenation capacity, pulmonary vascular resistance (PVR), lung compliance (LC), and biopsy. RESULTS: The arterial oxygen pressure (with inspired oxygen fraction of 100%) increased from a mean of 206 mm Hg in the organ donor at the referring hospital to a mean of 498 mm Hg during the ex vivo evaluation. After 1 hour of EVLP, PVR varied from 440-1454 dynes/sec/cm(5); LC was in the range of 26-90 mL/cmH(2)O. There was no histological deterioration after 10 hours of cold ischemia and 1 hour of EVLP. CONCLUSIONS: The ex vivo evaluation model can improve oxygenation capacity of "marginal" lungs rejected for transplantation. It has great potential to increase lung donor availability and, possibly, reduce time on the waiting list. |
| | |
Authors:
|
P M Pêgo-Fernandes; I L de Medeiros; A W Mariani; F G Fernandes; F D V Unterpertinger; M N Samano; E D C Werebe; M Canzian; F B Jatene |
Related Documents
:
|
8567579 - Effects of ventilation and pleural effusion on measurements of airway thermal volume an... 16424709 - Ventilatory and hemodynamic management of potential organ donors: an observational survey. 6807159 - Plasma volume expansion in canine pneumococcal pneumonia: its effects on respiratory ga... 16774869 - Airflow distribution in the human lung and its influence on particle deposition. 3233049 - Effects of progressively increased doses of theophylline and of s 9795 on hemodynamics,... 17046849 - Quantification of atelectatic lung volumes in two different porcine models of ards. 17417979 - Respiratory controversies in the critical care setting. does airway pressure release ve... 12048459 - Vicair academy mattress in the prevention of pressure damage. 8908669 - Intrinsic urethral closure mechanisms in the female pig. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Transplantation proceedings Volume: 42 ISSN: 1873-2623 ISO Abbreviation: Transplant. Proc. Publication Date: 2010 Mar |
Date Detail:
|
Created Date: 2010-03-22 Completed Date: 2010-08-19 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
|
Languages: eng Pagination: 440-3 Citation Subset: IM |
Copyright Information:
|
Copyright (c) 2010 Elsevier Inc. All rights reserved. |
Affiliation:
|
Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. paulopego@incor.usp.br |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Blood Gas Analysis Cadaver Cause of Death Female Humans Lung / blood supply*, pathology, physiopathology Lung Compliance Lung Transplantation / physiology*, statistics & numerical data Male Middle Aged Organ Preservation / methods Patient Selection* Perfusion / methods Positive-Pressure Respiration Refusal to Treat / statistics & numerical data Tissue Donors Vascular Resistance |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Analysis of the Liver Effluent as a Marker of Preservation Injury and Early Graft Performance.
Next Document: Experimental Model of Isolated Lung Perfusion in Rats: First Brazilian Experience Using the IL-2 Iso...