Boudreaux Joel C, Urban Marian, Berkheim David B, Small Bronwyn, Strah Heather M, Siddique Aleem
College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
Division of Cardiothoracic Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
Ann Thorac Surg Short Rep. 2023 Jun 15;1(4):562-565. doi: 10.1016/j.atssr.2023.05.021. eCollection 2023 Dec.
Mobile ex vivo lung perfusion (mEVLP) allows transportation of lung allografts while maintaining ventilation and perfusion and has demonstrated safety and efficacy with the potential to expand organ utilization. A nationwide organ recovery service has been implemented to provide surgical expertise for recovery alongside mEVLP transportation services.
We reviewed patients at our institution who underwent lung transplantation with donor lungs procured with this program. Donor and recipient characteristics, procurement details, and outcomes were collected and descriptively analyzed. Individual patient consent was obtained.
Three patients underwent bilateral lung transplantation and 1 patient received a unilateral lung transplant with allografts procured by the recovery service. Three of the grafts were recovered from donation after circulatory death (DCD) donors and 1 from a brain-dead donor. One DCD donor was particularly challenging, requiring resternotomy. All allografts recovered were of acceptable quality and ultimately used for transplantation. The incidence of adverse events was low, and all patients survived to discharge.
A novel national mEVLP procurement service is safe and effective even in challenging procurements. Such a program may be beneficial to increase organ utilization through expanded use of lung donors in general and DCD donors in particular. Further study is warranted for the impact on transplant program resources, organ utilization, and outcomes.
移动体外肺灌注（mEVLP）可在维持通气和灌注的同时实现肺移植供体的运输，已证明其安全性和有效性，具有扩大器官利用的潜力。已实施一项全国性器官获取服务，以便在提供mEVLP运输服务的同时提供器官获取方面的外科专业知识。
我们回顾了在本机构接受肺移植的患者，这些患者的供肺是通过该项目获取的。收集了供体和受体的特征、获取细节及结果，并进行描述性分析。已获得患者个人同意。
3例患者接受了双侧肺移植，1例患者接受了单侧肺移植，所用移植物均由获取服务部门提供。其中3个移植物来自心脏死亡后捐赠（DCD）供体，1个来自脑死亡供体。1例DCD供体的获取极具挑战性，需要再次开胸手术。所有获取的移植物质量均可接受，最终用于移植。不良事件发生率较低，所有患者均存活至出院。
一项新型的全国性mEVLP获取服务即使在具有挑战性的获取过程中也是安全有效的。这样一个项目可能有利于通过更广泛地使用肺供体，特别是DCD供体来提高器官利用率。有必要进一步研究其对移植项目资源、器官利用及结果的影响。
