Clinical Outcomes of over 500 Lung Transplants using Ex vivo Lung Perfusion: A Large Volume Single Center Retrospective Analysis
Presented During:
Sunday, May 7, 2023: 5:17PM - 5:32PM
Los Angeles Convention Center
Posted Room Name:
408A
Abstract No:
172
Submission Type:
Abstract Submission
Authors:
Aadil Ali (1), Gabriel Siebiger (2), George Tomlinson (2), Elliot Wakeam (2), Jonathan Yeung (3), Laura Donahoe (3), Kazuhiro Yasufuku (3), Andrew Pierre (4), Marc de Perrot (3), Thomas Waddell (5), Shaf Keshavjee (6), Marcelo Cypel (3)
Institutions:
(1) Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, (2) University of Toronto, Toronto, NA, (3) Toronto General Hospital, Toronto, ON, (4) N/A, Toronto, ON, (5) University Health Network, Toronto, ON, (6) Toronto General Hospital, University Health Network, Toronto, ON
Submitting Author:
Aadil Ali
-
Contact Me
Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute
Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute
Co-Author(s):
Gabriel Siebiger
-
Contact Me
University of Toronto
University of Toronto
George Tomlinson
-
Contact Me
University of Toronto
University of Toronto
Elliot Wakeam
-
Contact Me
University of Toronto
University of Toronto
Jonathan Yeung
-
Contact Me
Toronto General Hospital
Toronto General Hospital
Laura Donahoe
-
Contact Me
Toronto General Hospital
Toronto General Hospital
*Kazuhiro Yasufuku
-
Contact Me
Toronto General Hospital
Toronto General Hospital
Andrew Pierre
-
Contact Me
N/A
N/A
*Marc de Perrot
-
Contact Me
Toronto General Hospital
Toronto General Hospital
*Thomas Waddell
-
Contact Me
University Health Network
University Health Network
*Shaf Keshavjee
-
Contact Me
Toronto General Hospital, University Health Network
Toronto General Hospital, University Health Network
*Marcelo Cypel
-
Contact Me
Toronto General Hospital
Toronto General Hospital
Presenting Author:
Aadil Ali
-
Contact Me
Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute
Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute
Abstract:
Objective: To compare the outcomes of patients receiving lungs transplanted after undergoing ex vivo lung perfusion (EVLP) versus those transplanted conventionally at a single-center with over 14 years of experience.
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.
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.
THORACIC:
End Stage Lung Disease and Lung Transplantation
Image or Table
