Erasmus Michiel E, Fernhout Meine H, Elstrodt Jan M, Rakhorst Gerhard
Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Transpl Int. 2006 Jul;19(7):589-93. doi: 10.1111/j.1432-2277.2006.00318.x.
Donor shortage urges optimal use of all lungs available. Ex vivo lung perfusion (EVLP) is a method to evaluate lung function before implantation. EVLP was performed in pigs to evaluate lung function, using two different clinical non-heart-beating (NHS) donor protocols: flush perfusion and topical cooling after 1-h warm ischaemia (n = 5 each). Secondly, we investigated whether EVLP can be used for 6 h ex vivo machine preservation (n = 4). In comparison with topical cooling, flush perfusion preserved lung function better during EVLP. During 6 h normothermic EVLP, gas exchange remained stable; however, the pulmonary artery pressure and ventilation pressure showed a significant increase. EVLP is a reliable method for evaluation of lung graft function. Flush perfusion with Perfadex is preferred above topical cooling in NHB lung donation. Six-hour normothermic EVLP is feasible but should be further improved to make ex vivo machine preservation or treatment of lung grafts successful.
供体短缺促使人们优化利用所有可用的肺脏。体外肺灌注（EVLP）是一种在植入前评估肺功能的方法。在猪身上进行了EVLP以评估肺功能，采用了两种不同的临床非心脏跳动（NHS）供体方案：冲洗灌注和1小时温热缺血后局部降温（每组n = 5）。其次，我们研究了EVLP是否可用于6小时的体外机器保存（n = 4）。与局部降温相比，冲洗灌注在EVLP期间能更好地保存肺功能。在6小时常温EVLP期间，气体交换保持稳定；然而，肺动脉压和通气压力显著升高。EVLP是评估肺移植功能的可靠方法。在NHB肺捐赠中，用Perfadex进行冲洗灌注优于局部降温。6小时常温EVLP是可行的，但应进一步改进以成功实现肺移植的体外机器保存或治疗。
