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Report of the ISHLT Working Group on Primary Lung Graft Dysfunction - Part IV: Prevention and Treatment A 2016 consensus group statement of The International Society for Heart and Lung Transplantation

Published on Oct 1, 2017in Journal of Heart and Lung Transplantation8.578
· DOI :10.1016/j.healun.2017.07.013
Dirk Vanraemdonck55
Estimated H-index: 55
(Katholieke Universiteit Leuven),
Matthew G. Hartwig26
Estimated H-index: 26
(Duke University)
+ 14 AuthorsShaf Keshavjee74
Estimated H-index: 74
(U of T: University of Toronto)
Abstract
  • References (230)
  • Citations (15)
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References230
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#1Laleh JalilianH-Index: 1
56 CitationsSource
#1A. Slama (Medical University of Vienna)H-Index: 4
#2Lukas Schillab (Medical University of Vienna)H-Index: 1
Last. Clemens Aigner (Medical University of Vienna)H-Index: 21
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Background Ex vivo lung perfusion (EVLP) was primarily developed for evaluation of impaired donor lungs. The good clinical results raise the question for its possible impact on lungs meeting standard criteria. Before application of EVLP on such lungs enters routine clinical practice, it must be demonstrated whether EVLP would affect or improve outcome when used in standard donor lungs. We performed a prospective randomized trial to investigate the role of EVLP in standard lung transplantation (T...
32 CitationsSource
#1Andrew J. Fisher (Newcastle upon Tyne Hospitals NHS Foundation Trust)H-Index: 34
#2Anders Andreasson (Newcastle University)H-Index: 5
Last. John H. Dark (Newcastle University)H-Index: 4
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Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use.The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in increasing UK lung transplant activity.A multicentre, unblinded, non-randomised, non-inferiority observational study to compare transp...
27 CitationsSource
#1Geraldine MacdonaldH-Index: 22
#2Nuala Livingstone ('QUB': Queen's University Belfast)H-Index: 7
Last. Rachel Churchill (UoB: University of Bristol)H-Index: 39
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BACKGROUND Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.
18 CitationsSource
OBJECTIVES: Lung transplantation (LTx) is an accepted therapy for selected infants, children and adolescents with end-stage lung and pulmonary vascular disease. It remains a challenge for a selected group of patients. In 2011, the number of paediatric lung transplantations (PLTxs) worldwide was 107. In France, a total of 131 PLTxs have been performed since 2000 (data from ABM: Agence de biomedecine), 65 of which were conducted at our institution. METHODS: All patients under 18 (4.8–17.11) years ...
4 CitationsSource
#1Fabio IusH-Index: 16
#2Wiebke SommerH-Index: 14
Last. Gregor WarneckeH-Index: 24
view all 19 authors...
Background Since April 2010, extracorporeal membrane oxygenation (ECMO) has replaced cardiopulmonary bypass for intraoperative support during lung transplantation at our institution. The aim of this study was to present our 5-year experience with this technique. Methods Records of patients who underwent transplantation between April 2010 and January 2015 were retrospectively reviewed. Patients who underwent transplantation without ECMO formed Group A. Patients in whom the indication for ECMO sup...
24 CitationsSource
#1B. Gohrbandt (MHH: Hannover Medical School)H-Index: 2
#2Gregor Warnecke (MHH: Hannover Medical School)H-Index: 24
Last. Martin Strüber (MHH: Hannover Medical School)H-Index: 41
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Historically, grafts were preserved by means of autoperfusion with extracorporeal circulation, topical cooling or donor core cooling. In the 1980s, the standard lung preservation method was single pulmonary artery flush perfusion, using modified Euro-Collins solution at 4°C [1]. However, reperfusion injury remained a significant factor for morbidity and early mortality after lung transplant. Since the early years of lung preservation strategies, some advances have emerged in transplant teams, su...
3 CitationsSource
#1Michael Kuan Yew Hsin (U of T: University of Toronto)H-Index: 1
#2Ilker Iskender (U of T: University of Toronto)H-Index: 9
Last. Marcelo Cypel (U of T: University of Toronto)H-Index: 33
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Background Ex vivo lung perfusion (EVLP) allows normothermic evaluation and treatment of donor lungs not currently acceptable for transplant and improves organ use. Donor lungs undergo a period of cold preservation before (cold ischemic time [CIT]-1) and after (CIT-2) EVLP. We investigated the effect of an extended CIT-2 on lung function after transplantation. Methods Explanted pig lungs, preserved in low-potassium dextran flush (Perfadex) at 4°C for 10 hours, were subjected to 6 hours of EVLP. ...
21 CitationsSource
Background The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). Methods In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 center...
70 CitationsSource
This section of the 32nd official International Society for Heart and Lung Transplantation (ISHLT) Registry Report of 2015 summarizes data from 51,440 adult lung and 3,820 adult heart-lung transplants that occurred through June 30, 2014. This publication reports data for donor and recipient characteristics, transplant events, and recipient treatments and outcomes. This Registry Report focuses on an overall theme of recipient early graft failure. The Registry’s online full slide set provides more...
296 CitationsSource
Cited By15
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#1Ahmed E. Hozain (CUMC: Columbia University Medical Center)H-Index: 1
#2Yuliya Tipograf (Vandy: Vanderbilt University)H-Index: 1
Last. Matthew Bacchetta (Vandy: Vanderbilt University)H-Index: 22
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Structured Abstract Objectives Lung remains the least utilized solid organ for transplantation. Efforts to recover donor lungs with reversible injuries using ex-vivo perfusion systems are limited to less than 24 hours of support. Here, we demonstrate the feasibility of extending normothermic extracorporeal lung support to 4 days using cross-circulation with conscious swine. Methods A swine behavioral training program and custom enclosure were developed to enable multi-day cross-circulation betwe...
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#1Barbara J. Wilkey (University of Colorado Denver)H-Index: 3
#2Benjamin A. Abrams (University of Colorado Denver)H-Index: 1
Primary graft dysfunction (PGD) is a form of acute lung injury that develops within the first 72 hours after lung transplantation. The overall incidence of PGD is estimated to be around 30%, and th...
1 CitationsSource
#1Jessica H. HustonH-Index: 1
#2Evan L. BrittainH-Index: 16
Last. Ivan M. RobbinsH-Index: 39
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Pulmonary arterial hypertension is a highly morbid disease with limited treatment options that improve survival and currently the only curative treatment is transplantation. There is a small body of literature comparing the efficacy of lung and heart-lung transplantation in this population. The bulk of evidence suggests that most patients with severe right ventricular failure undergoing transplant will have recovery of right ventricular function after lung transplantation. Existing data suggest ...
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#1André Euler (UZH: University of Zurich)
#2Christian Blüthgen (UZH: University of Zurich)H-Index: 2
Last. Andreas Boss (UZH: University of Zurich)H-Index: 33
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#1Janne Brouckaert (Katholieke Universiteit Leuven)
#2Stijn Verleden (CUA: The Catholic University of America)H-Index: 2
Last. Dirk Vanraemdonck (CUA: The Catholic University of America)H-Index: 55
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Rationale . Lung transplantation is the only definitive treatment in end-stage pulmonary disease. Extracorporeal membrane oxygenation (ECMO) has been used during surgery in recent years as a replacement for respiratory function; ECMO, however, has some drawbacks: the presence of an extracorporeal circuit, the need for heparinization, potential thrombogenicity that underlies the risks of developing specific complications that worsen the transplantation prognosis. In this regard, it is relevant to...
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#1Gabriel Loor (The Texas Heart Institute)H-Index: 9
#2Amit Parulekar (Baylor University)H-Index: 1
Last. Michael A. Smith (St. Joseph's Hospital and Medical Center)H-Index: 10
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2 CitationsSource
#1Stacey BrannH-Index: 1
#2Steven S. GeierH-Index: 2
Last. Yoshiya ToyodaH-Index: 36
view all 6 authors...
Source
Ex vivo lung perfusion implies perfusion and ventilation of a donor lung outside of the human body. The 2 most clinically relevant and commercially available devices currently in clinical trials are XVIVO Perfusion System (XPS Perfusion, Goteborg, Sweden) and Organ Care System (Transmedics, Andover, MA). Our review focuses on the needs met by ex vivo lung perfusion, and the clinical literature on both devices.
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#1Mariya Geube (Cleveland Clinic Lerner College of Medicine)
#2Balaram Anandamurthy (Cleveland Clinic Lerner College of Medicine)
Last. Jean-Pierre Yared (Cleveland Clinic)H-Index: 17
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