Modernized Solutions for Lung Failure, From Bench to Bedside
The Impact of Various Ex Vivo Lung Perfusion Strategies on Transplantation Outcomes: A Comprehensive Analysis of Data from the United Network for Organ Sharing
Sunday, January 26, 2025
8:20am – 8:30am PT
Location: 408A
A. Alzahrani1, K. Noda2, E. G.. Chan3, J. Ryan4, M. Furukawa4, C. Hage5, P. Sanchez6 1UPMC, Pittsburgh, Pennsylvania 2PhD, Pittsburgh, Pennsylvania 3University of Pittsburgh MedicalCenter, Pittsburgh, Pennsylvania 4University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 5MD, Pittsburgh, Pennsylvania 6MD, PhD, Pittsburgh, Pennsylvania
Disclosure(s):
Amer Alzahrani, n/a: No financial relationships to disclose
Purpose: Ex vivo lung perfusion (EVLP) can increase lung utilization from the donor pool by evaluating high-risk donors. This study evaluates the practices in the United States using different EVLP strategies and their impact on transplant outcomes. Methods: The characteristics of donors and recipients who underwent double lung transplants between September 2016 and March 2024 were obtained from the United Network for Organ Sharing database. Based on the lung preservation strategy used prior to transplantation, donors and recipients were categorized into hospital EVLP, EVLP facility, mobile EVLP, or standard transplant (Tx). Results: The study included 14,730 transplants; 826 donor lungs placed on EVLP prior to transplantation. DCD lungs were more in the EVLP groups than the standard Tx group (29% and 6.3%, respectively; p < 0.001) and were associated with worse survival. EVLP groups had longer ischemic times (16.17 hours, EVLP facility; 13.03 hours, hospital EVLP; 10.30 hours, mobile EVLP) than the standard Tx group (5.82 hours) and were associated with worse survival. The EVLP facility and mobile EVLP groups had higher rates of grade 3 primary graft dysfunction (26% and 27%, respectively) than the standard Tx group (18%; p < 0.001). EVLP groups experienced longer hospital stays. Mobile EVLP recipients had significantly lower 3-year survival rates (p = 0.02) compared to the standard Tx group. Conclusion: The EVLP group, particularly EVLP post-DCD, performed worse than the standard group. Additionally, different EVLP strategies showed significant variations in post-transplant outcomes. As more national and international data becomes available, ongoing analysis is crucial to better understand and define the role of these technologies.
Identify the source of the funding for this research project: No Funding, No financial disclosure.
