The Journal of Thoracic and Cardiovascular Surgery
Thoracic: Lung TransplantationEx vivo lung evaluation of single donor lungs when the contralateral lung is rejected increases safe use
Graphical abstract
Section snippets
Methods
Data were retrospectively extracted from the prospectively collected database of the Toronto Lung Transplant Program. The study was approved by the University Health Network Research Ethics Board (18-6346) on February 2, 2019. A waiver for informed consent was provided, given the nature of the study.
To account for the introduction of clinical EVLP to our program in 2008, we considered the years 2000 to 2008 the “pre-EVLP era” and 2009 to 2017 the “EVLP era.” When one lung was declined at the
Results
A total of 1692 transplants were performed between 2000 and 2017, of which 244 (14%) were SLT. The proportion of SLT was similar between eras (66/524 [16%] pre-EVLP era vs 178/1168 [15%] EVLP era), but more SLTs were performed when the contralateral lung was declined in the EVLP era (21/66 SLTs [32%] pre-EVLP era vs 80/178 [45%] EVLP era, P = .04).
There were 21 (9%) in group 1, 33 (14%) in group 2a, and 47 (19%) in group 2b. Of the 47 in group 2b, 28 (60%) were started on EVLP as a double lung
Discussion
SLT is a valuable option for many patients and presents the opportunity for gaining maximal societal benefit from the scarce pool of donor organs, which remains a priority for transplantation in general.3,10,11 Accepting a single lung for transplant when the contralateral lung is deemed unsuitable could be an avenue for expanding the number of available lungs for transplant, but these are potentially greater-risk organs since the injurious process affecting one of the lungs may also have
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The Advent of Semi-Elective Lung Transplantation—Prolonged Static Cold Storage at 10°C
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The editorial review of this paper was handled by Associate Editor David Jones, MD.