172. Clinical Outcomes of Over 500 Lung Transplants Using Ex Vivo Lung Perfusion: A Large Volume Single Center Retrospective Analysis
University Hospital Zurich
Zurich, NY
Switzerland - Contact Me
Professor Isabelle Opitz is Director of the Department of Thoracic Surgery, University Hospital Zurich, Switzerland, and Chair of the Lung Cancer Center of the University Hospital Zurich. She is past president of the European Society of Thoracic Surgery and International Director of AATS, where she serves on the AATS International Thoracic Surgical Oncology Summit Program Committee.
Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute
0, OH
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.
Sunday, May 7, 2023: 5:17 PM - 5:32 PM
15 Minutes
Los Angeles Convention Center
Room: 408A
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.
Presentation Duration
7 minute presentation; 7 minute discussion