• Doug A Gouchoe, Pablo G Sanchez, Jonathan D'Cunha, Christian A Bermudez, Mani A Daneshmand, Robert D Davis, Matthew G Hartwig, Thomas C Wozniak, Zachary N Kon, Bartley P Griffith, William R Lynch, Tiago N Machuca, Michael J Weyant, Michael E Jessen, Michael S Mulligan, Frank D'Ovidio, Phillip C Camp, Edward Cantu, Bryan A Whitson, and NOVEL and NOVEL Extension Trial Investigators.
• Division of Cardiac Surgery, Department of Surgery, The Ohio State University Wexner Center, College of Medicine, Columbus, Ohio; 88th Surgical Operations Squadron, Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio.
• J. Thorac. Cardiovasc. Surg. 2024 Sep 1; 168 (3): 724734.e7724-734.e7.

ObjectiveDonation after circulatory death (DCD) donors offer the ability to expand the lung donor pool and ex vivo lung perfusion (EVLP) further contributes to this ability by allowing for additional evaluation and resuscitation of these extended criteria donors. We sought to determine the outcomes of recipients receiving organs from DCD EVLP donors in a multicenter setting.MethodsThis was an unplanned post hoc analysis of a multicenter, prospective, nonrandomized trial that took place during 2011 to 2017 with 3 years of follow-up. Patients were placed into 3 groups based off procurement strategy: brain-dead donor (control), brain-dead donor evaluated by EVLP, and DCD donors evaluated by EVLP. The primary outcomes were severe primary graft dysfunction at 72 hours and survival. Secondary outcomes included select perioperative outcomes, and 1-year and 3-years allograft function and quality of life measures.ResultsThe DCD EVLP group had significantly higher incidence of severe primary graft dysfunction at 72 hours (P = .03), longer days on mechanical ventilation (P < .001) and in-hospital length of stay (P = .045). Survival at 3 years was 76.5% (95% CI, 69.2%-84.7%) for the control group, 68.3% (95% CI, 58.9%-79.1%) for the brain-dead donor group, and 60.7% (95% CI, 45.1%-81.8%) for the DCD group (P = .36). At 3-year follow-up, presence observed bronchiolitis obliterans syndrome or quality of life metrics did not differ among the groups.ConclusionsAlthough DCD EVLP allografts might not be appropriate to transplant in every candidate recipient, the expansion of their use might afford recipients stagnant on the waitlist a viable therapy.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

35 keywords...

hide…