Donor Lung Preservation at 10°C: Clinical and Logistical Impact.

Autor:	Gil Barturen M; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Laporta Hernández R; Pneumology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Romero Berrocal A; Anesthesiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Pérez Redondo M; Transplant Coordination and Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Gómez Lozano N; Immunology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Martín López J; Pathology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Royuela Vicente A; Biostatistics Unit; Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain., Romero Román A; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Hoyos Mejía L; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Crowley Carrasco S; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Gómez de Antonio D; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Naranjo Gómez JM; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Córdoba Peláez M; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Novoa NM; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain., Campo-Cañaveral de la Cruz JL; Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain; Universidad Europea de Madrid, Department of Medicine, Spain. Electronic address: jluiscampo82@gmail.com.
Jazyk:	English; Spanish; Castilian
Zdroj:	Archivos de bronconeumologia [Arch Bronconeumol] 2024 Jun; Vol. 60 (6), pp. 336-343. Date of Electronic Publication: 2024 Apr 06.
DOI:	10.1016/j.arbres.2024.03.021
Abstrakt:	Introduction: Cold static donor lung preservation at 10°C appears to be a promising method to safely extend the cold ischemic time (CIT) and improve lung transplant (LTx) logistics. Methods: LTx from November 2021 to February 2023 were included in this single institution, prospective, non-randomized study comparing prolonged preservation at 10°C versus standard preservation on ice. The inclusion criteria for 10°C preservation were suitable grafts for LTx without any donor retrieval concerns. Primary Endpoint: primary graft dysfunction (PGD) grade-3 at 72-h. Secondary endpoints: clinical outcomes, cytokine profile and logistical impact. Results: Thirty-three out of fifty-seven cases were preserved at 10°C. Donor and recipient characteristics were similar across the groups. Total preservation times (h:min) were longer (p<0.001) in the 10°C group [1st lung: median 12:09 (IQR 9:23-13:29); 2nd: 14:24 (12:00-16:20)] vs. standard group [1st lung: median 5:47 (IQR 5:18-6:40); 2nd: 7:15 (6:33-7:40)]. PGD grade-3 at 72-h was 9.4% in 10°C group vs. 12.5% in standard group (p=0.440). Length of mechanical ventilation (MV), ICU and hospital stays were similar in both groups. Thirty and ninety-day mortality rates were 0% in 10°C group (vs. 4.2% in standard group). IL-8 concentration was significantly higher 6-h post-LTx in the standard group (p=0.025) and IL-10 concentration was increased 72-h post-LTx in the 10°C group (p=0.045). Conclusions: Preservation at 10°C may represent a safe and feasible strategy to intentionally prolong the CIT. In our center, extending the CIT at 10°C may allow for semi-elective LTx and improve logistics with similar outcomes compared to the current standard preservation on ice. (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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