Universität zu Köln

Zeriouh, Mohamed, Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Mohite, Prashant N., Zych, Bartlomiej, Patil, Nikhil P., Garic-Saez, Diana, Koch, Achim, Weymann, Alexander, Soresi, Simona, Wippermann, Jens, Wahlers, Thorsten, De Robertis, Fabio, Popov, Aron-Frederik ORCID: 0000-0003-4226-3004 and Simon, Andre R. (2016). Utilization of the organ care system for bilateral lung transplantation: preliminary results of a comparative study. Interact Cardiovasc. Thorac. Surg., 23 (3). S. 351 - 358. OXFORD: OXFORD UNIV PRESS. ISSN 1569-9285

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Abstract

OBJECTIVES: Lung transplantation (LTx) remains the gold standard for patients with end-stage lung disease. However, due to donor organ shortage and brain stem death-related lung injury, only a small proportion of lungs are used increasing the mortality rate on the waiting list. A portable normothermic continuous ex vivo perfusion using the organ care system (OCS) represents one of the tools to increase the pool of donor organs and to improve the function of marginal lungs. We sought to assess mid-term outcomes after LTx using OCS and to compare outcomes including overall survival and freedom from bronchiolitis obliterans syndrome (BOS) with those after conventional preservation. METHODS: Included were 322 consecutive LTx performed at Harefield Hospital between January 2007 and December 2014. Recipients were divided into two groups depending on the organ storage strategy: the majority of patients (n = 308) were transplanted using lungs after cold storage (cold storage group), whereas 14 organs were preserved using OCS (OCS group). The primary end-points were overall survival and freedom from BOS after LTx. The secondary end-points were perioperative clinical characteristics and adverse events. RESULTS: There were no statistically significant differences in terms of most baseline donor and recipient characteristics. The percentage of heavy smokers among donors [8 (2.9%) vs 6 (42.9%), P < 0.001] and the median number of pack-years smoked by donors [14 (7; 24) vs 25 (24; 30), P = 0.026] were statistically higher in the OCS group. Patients from the OCS group had significantly better postoperative FEV1 at 3 [69 (54; 86) vs 93 (87; 89), P < 0.001] and 6 [77 (60; 90) vs 94 (84; 100), P = 0.006] months. There were no statistically significant differences in terms of cumulative survival and freedom from BOS between the two groups. CONCLUSIONS: Results after LTx using OCS are acceptable with excellent survival, and superior early outcome in terms of postoperative lung function despite higher risk in the OCS group. Further larger prospective trials are warranted to confirm our preliminary results and to elaborate long-term outcomes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED orcid.org/0000-0002-6289-1035 UNSPECIFIED Mohite, Prashant N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zych, Bartlomiej UNSPECIFIED UNSPECIFIED UNSPECIFIED Patil, Nikhil P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Garic-Saez, Diana UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Soresi, Simona UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED De Robertis, Fabio UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED Simon, Andre R. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-264112
DOI:	10.1093/icvts/ivw135
Journal or Publication Title:	Interact Cardiovasc. Thorac. Surg.
Volume:	23
Number:	3
Page Range:	S. 351 - 358
Date:	2016
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1569-9285
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RISK-FACTORS; DONOR LUNGS; PERFUSION; DEATH; CRITERIA; DONATION; HEART; STATE; ART Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26411