Fildes James E, Archer Louise D, Blaikley John, Ball Alexandra L, Stone John P, Sjöberg Trygve, Steen Stig, Yonan Nizar
1 The Transplant Centre, University Hospital of South Manchester, Manchester, United Kingdom. 2 The Manchester Collaborative Centre for Inflammation Research, University of Manchester, Manchester, United Kingdom. 3 Department of Cardiothoracic Surgery, Lund University Hospital, Sweden.
Transplantation. 2015 May;99(5):1078-83. doi: 10.1097/TP.0000000000000462.
Lung transplantation is limited by a scarcity of suitable donors resulting in high waiting list mortality. Ex vivo lung perfusion (EVLP) allows the evaluation and reconditioning of marginal donor lungs for use in transplantation. This study aimed to compare clinical outcome of patients transplanted with marginal organs by means of EVLP with a standard lung transplant cohort through a multicenter open trial.
Group 1 (n = 9) included patients transplanted using EVLP reconditioned marginal lungs. Group 2 (n = 46) consisted of date-matched patients transplanted using standard transplantation of acceptable lungs. The primary composite endpoint included acute rejection and infection at 12 months after transplantation.
There was no significant difference in the overall incidence of acute rejection (P = 0.754) and the number of treated infection episodes (proven/probable pneumonia; P = 0.857/0.368 and proven/probable tracheobronchitis; P = 0.226/0.529) up to 12 months after transplantation, between group 1 and group 2. Additionally, there was no significant difference in early clinical outcome, including intensive care unit stay, hospital stay, and 1 year mortality between the two groups (P = 0.338, P = 0.112 and P = 0.372, respectively).
This multicenter study demonstrates that EVLP is associated with no adverse effect on clinical outcome, including the incidence of acute rejection and infection after lung transplantation.
肺移植因合适供体稀缺而受限，导致等待名单上的死亡率很高。体外肺灌注（EVLP）可对边缘供体肺进行评估和修复，以用于移植。本研究旨在通过一项多中心开放性试验，比较经EVLP使用边缘器官进行移植的患者与标准肺移植队列患者的临床结局。
第1组（n = 9）包括使用经EVLP修复的边缘肺进行移植的患者。第2组（n = 46）由使用可接受肺的标准移植方法进行移植的日期匹配患者组成。主要复合终点包括移植后12个月时的急性排斥反应和感染。
在移植后长达12个月时，第1组和第2组之间的急性排斥反应总体发生率（P = 0.754）以及治疗的感染发作次数（确诊/疑似肺炎；P = 0.857/0.368和确诊/疑似气管支气管炎；P = 0.226/0.529）均无显著差异。此外，两组之间的早期临床结局，包括重症监护病房停留时间、住院时间和1年死亡率，也无显著差异（分别为P = 0.338、P = 0.112和P = 0.372）。
这项多中心研究表明，EVLP对临床结局无不良影响，包括肺移植后的急性排斥反应和感染发生率。
