The First Experience of Lung Perfusion (EVLP) in Iran: An Effective Method to Increase Suitable Lung for Transplantation.

BACKGROUND

Although lung transplantation is a well-accepted treatment for end-stage lung diseases patients, only 15%-20% of the brain-dead donors' lungs are usable for transplantation. This results in high mortality of candidates on waiting lists. lung perfusion (EVLP) is a novel method for better evaluation of a potential lung for transplantation.

OBJECTIVE

To report the first experience of EVLP in Iran.

METHODS

The study included a pig in Vienna Medical University, Vienna, Austria, and 4 humans in Masih Daneshvari Hospital, Tehran, Iran. All brain-dead donors from 2013 to 2015 in Tehran were evaluated for EVLP. Donors without signs of severe chest trauma or pneumonia, with poor oxygenation were included.

RESULTS

An increasing trend in difference between the pulmonary arterial pO and left atrial pO, an increasing pattern in dynamic lung compliance, and a decreasing trend in the pulmonary vascular resistance, were observed.

CONCLUSION

The initial experience of EVLP in Iran was successful in terms of important/critical parameters. The results emphasize on some important considerations such as precisely following standard lung harvesting and monitoring temperature and pressure. EVLP technique may not be a cost-effective option for low-income countries at first glance. However, because this is the only therapeutic treatment for end-stage lung disease, it is advisable to continue working on this method to find alternatives with lesser costs.