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

• Mariana Gil Barturen ^[1] ; Rosalía Laporta Hernández ^[2] ; Antonio Romero Berrocal ^[3] ; Marina Pérez Redondo ^[4] ; Natalia Gómez Lozano ^[5] ; Javier Martín López ^[6] ; Ana Royuela Vicente ^[7] ; Alejandra Romero Román ^[1] ; Lucas Hoyos Mejía ^[1] ; Silvana Crowley Carrasco ^[1] ; David Gómez de Antonio ^[1] ; Jose Manuel Naranjo Gómez ^[1] ; Mar Córdoba Peláez ^[1] ; Nuria María Novoa ^[1] ; Jose Luis Campo Cañaveral de la Cruz ^[1]
  1. [1] Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
  2. [2] Pneumology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
  3. [3] Anesthesiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
  4. [4] Transplant Coordination and Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
  5. [5] Immunology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
  6. [6] Pathology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
  7. [7] Biostatistics Unit; Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 60, Nº. 6, 2024, págs. 336-343
• Idioma: inglés
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• Resumen

  • 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.