Author/Authors :
shafaghi, s shahid beheshti university of medical science , najafizadeh, k shahid beheshti university of medical science , sheikhy, k shahid beheshti university of medical science , ansari alavi, z shahid beheshti university of medical science , farzanegan, b shahid beheshti university of medical science , mafhoomi, y shahid beheshti university of medical science , faghih abdollahi, z shahid beheshti university of medical science , emami, h shahid beheshti university of medical science , mortaz, e shahid beheshti university of medical science , porabdollah, m shahid beheshti university of medical science , jahangiri fard, a shahid beheshti university of medical science , nikobayan safaiei, m shahid beheshti university of medical science , slama, a shahid beheshti university of medical science , aigner, c shahid beheshti university of medical science , hosseini- baharanchi, a shahid beheshti university of medical science , abbasi dezfuli, a shahid beheshti university of medical science
Abstract :
Background:
Although lung transplantation is a well-accepted treatment for end-stage lung diseases patients, only 15%–20% of the brain-dead donors’ lungs are usable for transplantation. This results in high mortality of candidates on waiting lists. Ex-vivo lung perfusion (EVLP) is a novel method for better evaluation of a potential lung for transplantation.
Objective:
To report the first experience of EVLP in Iran.
Methods:
The study included a pig in Vienna Medical University, Vienna, Austria, and 4 humans in Masih Daneshvari Hospital, Tehran, Iran. All brain-dead donors from 2013 to 2015 in Tehran were evaluated for EVLP. Donors without signs of severe chest trauma or pneumonia, with poor oxygenation were included.
Results:
An increasing trend in difference between the pulmonary arterial pO2 and left atrial pO2, an increasing pattern in dynamic lung compliance, and a decreasing trend in the pulmonary vascular resistance, were observed.
Conclusion:
The initial experience of EVLP in Iran was successful in terms of important/critical parameters. The results emphasize on some important considerations such as precisely following standard lung harvesting and monitoring temperature and pressure. EVLP technique may not be a cost-effective option for low-income countries at first glance. However, because this is the only therapeutic treatment for end-stage lung disease, it is advisable to continue working on this method to find alternatives with lesser costs.
Keywords :
Lung transplantation , Ex-vivo lung perfusion , Brain-dead donor , Lung transplantation technique
