172. Clinical Outcomes of Over 500 Lung Transplants Using Ex Vivo Lung Perfusion: A Large Volume Single Center Retrospective Analysis
University Hospital Zurich
Zurich, MA
Switzerland - Contact Me
Professor Isabelle Opitz is Director of the Department of Thoracic Surgery, Chair of the Lung Cancer Center, and Member of both the Robotic and the Transplant Center Board at University Hospital Zurich, Switzerland. She is Professor/Ordinaria for Thoracic Surgery at the University of Zurich. Her clinical areas of expertise are the surgical treatment of lung cancer, pleural mesothelioma, chronic thromboembolic pulmonary hypertension, and lung transplantation.
She has received several national and international awards for her research. She is Past President and Past Treasurer of the European Society of Thoracic Surgeons. For this society, she also works as a member of the Steering Committee of the Working Group Robotic, organizing the newly founded ESTS Robotic School and the Clinical Trials Working Group, implementing the Thoracic European Surgical Trials (TEST) Clinical Trials Platform.She is International Director of the American Association for Thoracic Surgeryand serves in their Thoracic Education Committee and the Thoracic Clinical Practice Standards Committee. She will be co-chair of IASLC World Conference on Lung Cancer 2025 and is a member of the ESMO 2025 scientific committee.
Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute
Toronto, ON
Canada - Contact Me
Aadil Ali completed his PhD at the University of Toronto under the direct supervision of Dr. Marcelo Cypel. His research focused on bringing forward static cold storage at 10 degrees celcius as a new standard of care. Aadil has published in numerous high impact journals and has recieved various awards for his work.
Description
Methods: Patient data was abstracted from the Toronto Lung Transplant Database between Jan 01, 2008 – Jan 01, 2022. Patients were separated based on whether they received lungs which underwent EVLP or whether they were transplanted conventionally (controls). Patients were matched 1:1 based on medical diagnosis, recipient status, recipient sex, recipient age, BMI, donor age, and calendar year. The primary outcome of the study was the incidence of Primary Graft Dysfunction (PGD) Grade 3 at 72h, with secondary outcomes of post-transplant mechanical ventilation, post-transplant hospital length of stay, intensive care unit (ICU) length of stay, allograft survival analysis and CLAD-Free survival analysis.
Results: There were a total of 533 patients in the EVLP group and 1317 controls. 62.3% of donor lungs placed on EVLP were from Donation after Cardiac Death (DCD) donors vs. 37.3% in the matched control group (P < 0.001). Mean donor P/F ratio was significantly lower for lungs in the EVLP group vs. controls (368 mmHg ± 102 mmHg vs. 426 mmHg ± 86 mmHg, P < 0.001). There were no differences in the incidence of PGD Grade 3 at 72h between the EVLP group and non-EVLP group (12.3% vs. 12.9%, P = 0.23). Furthermore, there were no differences in post-transplant length of mechanical ventilation [2 days (IQR 1 – 4 days) vs. 1.7 days (IQR 1 - 4.1 days), P = 0.1806], post-transplant hospital length of stay [22 days (IQR 16 – 40 days) vs. 25 days (IQR 16 – 42.6 days), P = 0.1730], ICU length of stay [4 days (IQR 2 – 9 days) vs. 4 days (IQR 2 – 11 days), P = 0.3090]. There were no significant differences in allograft survival probability between the two groups (Figure 1, P = 0.82), nor CLAD-Free survival between the groups (P = 0.88).
Conclusions: EVLP has been successfully incorporated in our program for over a decade and is a well-tolerated method to expand the organ donor pool without compromising post-transplant outcomes.