Extended travel for donor organs:Is cold static storage still relevant  

作　　者：Montana Reynolds Martin Gerard Walsh Ervin Y Cui Divyaam Satija Doug A Gouchoe Matthew C Henn Kukbin Choi Nahush A Mokadam Asvin M Ganapathi Bryan A Whitson 

机构地区：[1]COPPER Laboratory,Department of Surgery,The Ohio State University Wexner Medical Center,Columbus,OH 43201,United States [2]Division of Cardiac Surgery,Department of Surgery,The Ohio State University Wexner Medical Center,Columbus,OH 43201,United States

出　　处：《World Journal of Transplantation》2025年第3期164-174,共11页世界移植杂志(英文)

基　　金：Supported by The Jewel and Frank Benson Family Endowment;and The Jewel and Frank Benson Research Professorship.

摘　　要：BACKGROUND Traditional limitations of cold static storage(CSS)on ice at 4℃during lung transplantation have necessitated limiting cold ischemic time(CIT)to 4-6 hours.Ex vivo lung perfusion(EVLP)can extend this preservation time through the suspension of CIT and normothermic perfusion.As we continue to further expand the donor pool in all aspects of lung transplantation,teams are frequently traveling further distances to procure organs.AIM To determine the effect of CSS or EVLP on donors with extended travel distance[>750 nautical miles(NM)]to recipient.METHODS Lung transplants,whose donor traveled greater than 750 NM,were identified from the United Network for Organ Sharing Database.Recipients were stratified into either:CSS or EVLP,based on preservation method.Groups were assessed with comparative statistics and survival was assessed by Kaplan-Meier methods.A 3:1 propensity match was then created,and same analysis was repeated.RESULTS Prior to matching,those in the EVLP group had significantly increased postoperative morbidity to include dialysis,ventilator use,acute rejection,and treated rejection in the first year(P<0.05 for all).However,there were no significant differences in midterm survival(P=0.18).Following matching,those in the EVLP group again had significantly increased post-operative morbidity to include dialysis,extracorporeal membrane oxygenation use,ventilator use,and treated rejection in the first year(P<0.05 for all).As before,there were no significant differences in midterm survival following matching(P=0.08).CONCLUSION While there was no significant difference in survival,EVLP patients had increased peri-operative morbidity.With the advent of changes in CSS with 10℃storage further analysis is necessary to evaluate the best methods for utilizing organs from increased distances.

关 键 词：Transplantation lung Ex vivo lung perfusion Ischemic time Machine perfusion United Network for Organ Sharing Cold static storage Normothermic perfusion 

分 类 号：R655.3[医药卫生—外科学]