Abdalla Luis Gustavo, Oliveira-Braga Karina Andrighetti de, Fernandes Lucas Matos, Samano Marcos Naoyuki, Camerini Paula Refinetti, Pêgo-Fernandes Paulo Manuel
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2019 Jul 15;17(4):eAO4288. doi: 10.31744/einstein_journal/2019AO4288.
To assess the feasibility and impact of ex vivo lung perfusion with hyperoncotic solution (Steen Solution™) in the utilization of these organs in Brazil.
In this prospective study, we subjected five lungs considered to be high risk for transplantation to 4 hours of ex vivo lung perfusion, with evaluation of oxygenation capacity. High-risk donor lungs were defined by specific criteria, including inflammatory infiltrates, pulmonary edema and partial pressure of arterial oxygen less than 300mmHg (inspired oxygen fraction of 100%).
During reperfusion, the mean partial pressure of arterial oxygen (inspired oxygen fraction of 100%) of the lungs did not change significantly (p=0.315). In the first hour, the mean partial pressure of arterial oxygen was 302.7mmHg (±127.66mmHg); in the second hour, 214.2mmHg (±94.12mmHg); in the third hour, 214.4mmHg (±99.70mmHg); and in the fourth hour, 217.7mmHg (±73.93mmHg). Plasma levels of lactate and glucose remained stable during perfusion, with no statistical difference between the moments studied (p=0.216).
Ex vivo lung perfusion was reproduced in our center and ensured the preservation of lungs during the study period, which was 4 hours. The technique did not provide enough improvement for indicating organs for transplantation; therefore, it did not impact on use of these organs.
评估在巴西使用高渗溶液（Steen Solution™）进行离体肺灌注在这些器官利用中的可行性和影响。
在这项前瞻性研究中，我们对5个被认为移植风险高的肺进行了4小时的离体肺灌注，并评估了氧合能力。高风险供体肺通过特定标准定义，包括炎症浸润、肺水肿和动脉血氧分压低于300mmHg（吸入氧分数为100%）。
在再灌注期间，肺的平均动脉血氧分压（吸入氧分数为100%）没有显著变化（p = 0.315）。在第一个小时，平均动脉血氧分压为302.7mmHg（±127.66mmHg）；在第二个小时，为214.2mmHg（±94.12mmHg）；在第三个小时，为214.4mmHg（±99.70mmHg）；在第四个小时，为217.7mmHg（±73.93mmHg）。灌注期间血浆乳酸和葡萄糖水平保持稳定，所研究时间点之间无统计学差异（p = 0.216）。
我们中心成功再现了离体肺灌注，并在4小时的研究期间确保了肺的保存。该技术未提供足够的改善以表明这些器官可用于移植；因此，它对这些器官的使用没有影响。
