PMID- 30535021
OWN - NLM
STAT- MEDLINE
DCOM- 20200113
LR  - 20200113
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 28
IP  - 5
DP  - 2019 May 1
TI  - Significant parameters in the evaluation of donor lungs in single-lung cellular 
      ex vivo lung perfusion.
PG  - 767-774
LID - 10.1093/icvts/ivy327 [doi]
AB  - OBJECTIVES: Typically, single-lung ex vivo lung perfusion (SL-EVLP) is preferred 
      when there is concern of contamination from the opposite lung. However, a 
      comprehensive assessment of the SL-EVLP has not been completed. The purpose of 
      this study is to compare the physiological parameters of SL-EVLP and double-lung 
      EVLP (DL-EVLP) in the assessment of transplant suitability. METHODS: Seven pairs 
      of rejected donor lungs were perfused in cellular EVLP, with a tidal volume of 
      6 ml/kg ideal body weight and a perfusion flow of 70 ml/kg/min. The transplant 
      suitability of each side was judged in the DL-EVLP. Subsequently, the tidal 
      volume and flow were reduced by half. The right SL-EVLP was maintained for 10 min 
      by clamping the left main pulmonary artery and the bronchus. Similarly, left 
      SL-EVLP was performed. The physiological parameters were compared between SL-EVLP 
      and DL-EVLP. RESULTS: PO2/FiO2 ratio was significantly lower in SL-EVLP than in 
      DL-EVLP [182.5 (127.5-309.5) vs 311.5 (257.5-377.0) mmHg, P < 0.001]. There was a 
      significant correlation with a higher shunt fraction and PCO2 in the pulmonary 
      vein in SL-EVLP when compared to DL-EVLP. There was no difference in peak 
      inspiratory and plateau pressures between SL-EVLP and DL-EVLP. Suitable lungs 
      (n = 6) were associated with better PO2/FiO2 ratios and lower airway pressures 
      than non-suitable lungs (n = 8). CONCLUSIONS: In SL-EVLP, peak inspiratory and 
      plateau pressures have clinical utility in the assessment of the transplant 
      suitability. It is important that PO2/FiO2 ratio in SL-EVLP is appreciably lower 
      than that in DL-EVLP. This discrepancy should be considered in the evaluation of 
      the transplant suitability in SL-EVLP.
CI  - (c) The Author(s) 2018. Published by Oxford University Press on behalf of the 
      European Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Niikawa, Hiromichi
AU  - Niikawa H
AD  - Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 
      Cleveland, OH, USA.
AD  - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, 
      OH, USA.
FAU - Okamoto, Toshihiro
AU  - Okamoto T
AD  - Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 
      Cleveland, OH, USA.
AD  - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, 
      OH, USA.
AD  - Department of Transplant Center, Cleveland Clinic, Cleveland, OH, USA.
FAU - Ayyat, Kamal S
AU  - Ayyat KS
AD  - Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 
      Cleveland, OH, USA.
AD  - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, 
      OH, USA.
AD  - Department of Cardiothoracic Surgery, Faculty of Medicine, Zagazig University, 
      Zagazig, Egypt.
FAU - Itoda, Yoshifumi
AU  - Itoda Y
AD  - Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 
      Cleveland, OH, USA.
AD  - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, 
      OH, USA.
FAU - Hata, J Steven
AU  - Hata JS
AD  - Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH, USA.
FAU - McCurry, Kenneth R
AU  - McCurry KR
AD  - Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, 
      Cleveland, OH, USA.
AD  - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, 
      OH, USA.
AD  - Department of Transplant Center, Cleveland Clinic, Cleveland, OH, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Lung/*blood supply
MH  - *Lung Transplantation
MH  - Male
MH  - Middle Aged
MH  - Perfusion/*methods
MH  - Pressure
MH  - Pulmonary Artery
MH  - *Tissue Donors
MH  - Tissue and Organ Procurement/*methods
OTO - NOTNLM
OT  - Ex vivo lung perfusion
OT  - Evaluation of donor lungs
OT  - Single-lung ex vivo lung perfusion
OT  - Single-lung transplantation
EDAT- 2018/12/12 06:00
MHDA- 2020/01/14 06:00
CRDT- 2018/12/12 06:00
PHST- 2018/06/15 00:00 [received]
PHST- 2018/09/28 00:00 [revised]
PHST- 2018/10/28 00:00 [accepted]
PHST- 2018/12/12 06:00 [pubmed]
PHST- 2020/01/14 06:00 [medline]
PHST- 2018/12/12 06:00 [entrez]
AID - 5232583 [pii]
AID - 10.1093/icvts/ivy327 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2019 May 1;28(5):767-774. doi: 
      10.1093/icvts/ivy327.