Abstract
We report our successful experience in two lung transplant cases in which ex vivo lung perfusion (EVLP) was used to evaluate the function of injured brain-dead donor lungs that were otherwise initially unacceptable. After the donor’s lungs were declined for transplantation by all other transplant centers, the lungs were offered to the patients listed for lung transplantation in our hospital. The donor lung function was considered acceptable for transplantation after the 3-h EVLP assessment. In the first case, a 32-year-old man with bronchiolitis obliterans after hematopoietic stem cell transplantation underwent hybrid lung transplantation, that was right brain-dead donor lung transplantation, combined with native-upper lobe sparing living-donor lobar lung transplantation on the left side. In the second case, a 61-year-old woman received the right single lung transplantation for idiopathic pulmonary fibrosis. Both patients are doing well at one and a half years after lung transplantation.
Similar content being viewed by others
References
Steen S, Sjöberg T, Pierre L, Liao Q, Eriksson L, Algotsson L. Transplantation of lungs from a non-heart-beating donor. Lancet. 2001;357:825–9.
Cypel M, Yeung JC, Liu M, Anraku M, Chen F, Karolak W, et al. Normothermic ex vivo lung perfusion in clinical lung transplantation. N Engl J Med. 2011;364:1431–40.
Warnecke G, Van Raemdonck D, Smith MA, Massard G, Kukreja J, Rea F, et al. Normothermic ex-vivo preservation with the portable Organ Care System Lung device for bilateral lung transplantation (INSPIRE): a randomised, open-label, non-inferiority, phase 3 study. Lancet Respir Med. 2018;6:357–67.
Loor G, Warnecke G, Villavicencio MA, Smith MA, Kukreja J, Ardehali A, et al. Portable normothermic ex-vivo lung perfusion, ventilation, and functional assessment with the Organ Care System on donor lung use for transplantation from extended-criteria donors (EXPAND): a single-arm, pivotal trial. Lancet Respir Med. 2019;7:975–84.
Miyoshi K, Oto T, Konishi Y, Hirano Y, Okada M, Iga N, et al. Use of extended-criteria lungs on a lobe-by-lobe basis through ex vivo lung perfusion assessment. Ann Thorac Surg. 2015;99:1819–21.
Cypel M, Yeung JC, Hirayama S, Rubacha M, Fischer S, Anraku M, et al. Technique for prolonged normothermic ex vivo lung perfusion. J Heart Lung Transplant. 2008;27:1319–25.
Nakajima D, Date H. Ex vivo lung perfusion in lung transplantation. Gen Thorac Cardiovasc Surg. 2021;69:625–30.
Kurosaki T, Oto T, Otani S, Miyoshi K, Sugimoto S, Yamane M, et al. Hybrid lung transplantation combining living donor and cadaveric lung transplants: report of 2 cases. Transplant Proc. 2021;53:2004–7.
Fujinaga T, Bando T, Nakajima D, Sakamoto J, Chen F, Shoji T, et al. Living-donor lobar lung transplantation with sparing of bilateral native upper lobes: a novel strategy. J Heart Lung Transplant. 2011;30:351–3.
Sato M, Okada Y, Oto T, Minami M, Shiraishi T, Nagayasu T, et al. Registry of the Japanese Society of Lung and Heart-Lung Transplantation: official Japanese lung transplantation report, 2014. Gen Thorac Cardiovasc Surg. 2014;62:594–601.
Wigfield CH, Cypel M, Yeung J, Waddell T, Alex C, Johnson C, et al. Successful emergent lung transplantation after remote ex vivo perfusion optimization and transportation of donor lungs. Am J Transplant. 2012;12:2838–44.
Yeung JC, Krueger T, Yasufuku K, de Perrot M, Pierre AF, Waddell TK, et al. Outcomes after transplantation of lungs preserved for more than 12 h: a retrospective study. Lancet Respir Med. 2017;5:119–24.
Nakajima D, Cypel M, Martinu T, Liu M, Keshavjee S. Donor bronchial wash bile acid and suitability of donor lungs for transplantation. J Hear Lung Transplant. 2018;37:304–6.
Nakajima D, Liu M, Ohsumi A, Kalaf R, Iskender I, Hsin M, et al. Lung lavage and surfactant replacement during ex vivo lung perfusion for treatment of gastric acid aspiration-induced donor lung injury. J Hear Lung Transplant. 2017;36:577–85.
Nakajima D, Cypel M, Bonato R, Machuca TN, Iskender I, Hashimoto K, et al. Ex vivo perfusion treatment of infection in human donor lungs. Am J Transplant. 2016;16:1229–37.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Daisuke Nakajima, Toyofumi F. Chen-Yoshikawa, and Hiroshi Date received a research grant from Japan Agency for Medical Research and Development.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Nakajima, D., Nagata, S., Kayawake, H. et al. Successful lung transplant cases with ex vivo lung perfusion assessment of extended criteria donor lungs. Gen Thorac Cardiovasc Surg 70, 406–412 (2022). https://doi.org/10.1007/s11748-022-01774-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-022-01774-x