Hoetzenecker Konrad, Ali Aadil, Campo-Cañaveral de la Cruz Jose, Schwarz Stefan, Crowley Carrasco Silvana, Romero Roman Alexandra, Aladaileh Mohammed, Benazzo Alberto, Jaksch Peter, Wakeam Elliott, Aversa Meghan, Keshavjee Shaf, Cypel Marcelo
Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Deparment of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN.
Ann Surg. 2025 Apr 1;281(4):664-670. doi: 10.1097/SLA.0000000000006632. Epub 2025 Jan 16.
To determine the impact of prolonged storage of donor lungs at 10 °C for up to 24 hours on outcome after lung transplantation.
An increasing body of evidence suggests 10 °C as the optimal storage temperature for donor lungs. A recent study showed that cold ischemic times can be safely expanded to >12 hours when lungs are stored at 10 °C. However, it is currently unknown how long donor lungs can be preserved before they deteriorate in function.
Patients who received a donor lung stored at 10 °C between November 2020 and June 2023 at the lung transplant programs of Toronto, Vienna, and Madrid were included in this retrospective analysis. After excluding ex-vivo lung perfusion cases, recipients were grouped based on the total preservation times of their donor organs (<12 hours: n = 48; 12-18 hours: n = 109; ≥18 hours: n = 24). Three hundred seventy-two recipients who had received an organ stored on-ice during the study period served as a control group.
Length of lung preservation ranged from 2 hours 27 minutes to 29 hours 33 minutes (mean: 14 hours 06 minutes). Despite these prolonged preservation times, early postoperative outcomes were excellent. Median length of mechanical ventilation did not differ among the 3 study groups [<12 hours: 41 hours (interquartile range: 24-109); 12-18 hours: 56 hours (interquartile range: 24-143) and ≥18 hours: 59 hours (interquartile range: 28-108); P = 0.493]. Intensive care unit length of stay [6 days (4-14); 8 days (4-23); 8 days (5-32)] and hospital length of stay [32 days (20-48); 29 days (20-50); 26 days (17-50)] were also similar. Furthermore, the length of donor organ preservation had no impact on patient survival (log-rank P = 0.413).
Prolonged static preservation of donor lungs at 10 °C for up to 24 hours is safe and does not impair short-intermediate outcomes after lung transplantation.
确定供体肺在10℃下长时间保存长达24小时对肺移植术后结果的影响。
越来越多的证据表明10℃是供体肺的最佳保存温度。最近一项研究表明，当肺在10℃保存时，冷缺血时间可安全延长至>12小时。然而，目前尚不清楚供体肺在功能恶化前能够保存多长时间。
本回顾性分析纳入了2020年11月至2023年6月期间在多伦多、维也纳和马德里的肺移植项目中接受10℃保存的供体肺的患者。在排除体外肺灌注病例后，根据供体器官的总保存时间对受者进行分组（<12小时：n = 48；12 - 18小时：n = 109；≥18小时：n = 24）。372名在研究期间接受冰上保存器官的受者作为对照组。
肺保存时间从2小时27分钟到29小时33分钟不等（平均：14小时06分钟）。尽管保存时间延长，但术后早期结果良好。3个研究组之间机械通气的中位时间无差异（<12小时：41小时（四分位间距：24 - 109）；12 - 18小时：56小时（四分位间距：24 - 143）；≥18小时：59小时（四分位间距：28 - 108）；P = 0.493）。重症监护病房住院时间[6天（4 - 14）；8天（4 - 23）；8天（5 - 32）]和住院时间[32天（20 - 48）；29天（20 - 50）；26天（17 - 50）]也相似。此外，供体器官保存时间对患者生存无影响（对数秩检验P = 0.413）。
供体肺在10℃下长时间静态保存长达24小时是安全的，且不会损害肺移植术后的短期至中期结果。
