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(1233) Utilization and Outcomes with Single Lung Transplantation Following Ex Vivo Lung Perfusion Using a Centralized Lung Evaluation System at a Dedicated Facility

Mallea, J. ; Kon, Z. ; Brown, A. ; Hartwig, M. ; Sanchez, P. ; Keller, C. ; Erasmus, D. ; Dilling, D. ; D'Cunha, J. ; Roberts, M. ; Sketch, M.R. ; Johnson, D. ; McCurry, K.

The Journal of heart and lung transplantation, 2023-04, Vol.42 (4), p.S526-S527 [Periódico revisado por pares]

Elsevier Inc

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  • Título:
    (1233) Utilization and Outcomes with Single Lung Transplantation Following Ex Vivo Lung Perfusion Using a Centralized Lung Evaluation System at a Dedicated Facility
  • Autor: Mallea, J. ; Kon, Z. ; Brown, A. ; Hartwig, M. ; Sanchez, P. ; Keller, C. ; Erasmus, D. ; Dilling, D. ; D'Cunha, J. ; Roberts, M. ; Sketch, M.R. ; Johnson, D. ; McCurry, K.
  • É parte de: The Journal of heart and lung transplantation, 2023-04, Vol.42 (4), p.S526-S527
  • Descrição: Ex vivo lung perfusion (EVLP) could impact waitlist morbidity and mortality by increasing the number of transplantable allografts, including single lungs. We previously demonstrated feasibility of remote EVLP with a centralized lung evaluation system (CLES) at a dedicated facility (NCT02234128). Despite higher rate of primary graft dysfunction grade 3 at 72 hours (PGD3-72h) in the CLES cohort, survival to 3 years was similar to controls. We performed a post hoc analysis to understand outcomes of SLT and BLT with and without the use of CLES-based EVLP. Seven US centers referred lungs for remote EVLP to a dedicated CLES facility in a non-randomized, unblinded study. Controls underwent standard cold preservation and matched to CLES cohort by transplant type, center, and lung disease diagnosis group. Recipient characteristics and outcomes are summarized across SLT and BLT recipients in CLES and control cohorts. In the control (n=49) and CLES (n=66) cohorts, 41% and 47% of recipients received a SLT, respectively. SLT recipients tended to be older. Median Lung Allocation Score (LAS) was 36 in CLES-SLT, 35 in CLES-BLT, 39 in control-SLT, and 36 in control-BLT. PGD3-72h occurred in 8/31 (26%) CLES-SLT, 8/35 (23%) CLES-BLT, 1/20 (5%) control-SLT, and 1/29 (3%) control-BLT recipients. All recipients survived to 30-days. Survival at 1-year: 29/31 (94%) in CLES-SLT, 30/35 (86%) in CLES-BLT, 19/20 (95%) in control-SLT, and 26/29 (90%) in control-BLT recipients. Survival at 3-years: 24/31 (77%) in CLES-SLT, 26/35 (74%) in CLES-BLT, 13/20 (65%) in control-SLT, and 23/29 (79%) in control-BLT recipients. PGD3-72h was similar in SLT and BLT recipients within each cohort. At 1 year, survival appeared higher in SLT than BLT groups. At 3-years, survival was similar for SLT and BLT recipients in the CLES cohort and was higher in BLT than SLT recipients in controls. These data support application of remote EVLP with a CLES at a dedicated facility as an opportunity to increase utilization of SLT. Although there is a suggestion of improved survival to 3 years for recipients who received a CLES-SLT, these data should be interpreted with caution given small patient numbers and lack of statistical power. Future research should be focused on and powered to assess differences in outcomes for SLT with and without the use of CLES.
  • Editor: Elsevier Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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