Early results in transplantation of initially rejected donor lungs after ex vivo lung perfusion: a case-control study †

Abstract OBJECTIVES: An increasing number of studies have shown that ex vivo lung perfusion (EVLP) is safe and that rejected donor lungs can beresuscitated and used for lung transplantation (LTx). Early clinical outcomes in patientstransplanted with reconditioned lungs at ourcentrewere reviewed and compared with those of contemporary non-EVLP controls.METHODS: During 18 months starting January 2011, 11 pairs of donor lungs initially deemed unsuitable for transplantation underwentEVLP. Haemodynamic (pulmonary flow, vascular resistance and artery pressure) and respiratory (peak airway pressure and compliance)parameters were analysed during evaluation. Lungsthat improved (n=11) to meet International Societyof Heart and Lung Transplantationcriteriawere transplanted and compared with patientstransplanted with non-EVLP lungs (n=47) during the same time period.RESULTS: Donor lungs were initially rejected due to either inferior PaO 2 /FiO 2 ratio (n=9), bilateral infiltrate on chest X-ray (n=1) orongoing extra corporeal membrane oxygenation (n=1). The donor lungs improved from a mean PaO