Your browser doesn't support javascript.
loading
Prediction of donor related lung injury in clinical lung transplantation using a validated ex vivo lung perfusion inflammation score.
Sage, Andrew T; Richard-Greenblatt, Melissa; Zhong, Kathleen; Bai, Xiao Hui; Snow, Matthew B; Babits, Monica; Ali, Aadil; Baciu, Cristina; Yeung, Jonathan C; Liu, Mingyao; Cypel, Marcelo; Kain, Kevin C; Keshavjee, Shaf.
Afiliación
  • Sage AT; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Richard-Greenblatt M; Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, Canada.
  • Zhong K; Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, Canada.
  • Bai XH; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Snow MB; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Babits M; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Ali A; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Baciu C; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Yeung JC; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada; Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Liu M; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
  • Cypel M; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada; Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  • Kain KC; Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, Canada; Tropical Disease Unit, Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Keshavjee S; Toronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada; Division of Thoracic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. Electronic a
J Heart Lung Transplant ; 40(7): 687-695, 2021 07.
Article en En | MEDLINE | ID: mdl-33781664
BACKGROUND: Ex vivo lung perfusion (EVLP) is an isolated organ assessment technique that has revolutionized the field of lung transplantation and enabled a safe increase in the number of organs transplanted. The objective of this study was to develop a protein-based assay that would provide a precision medicine approach to lung injury assessment during EVLP. METHODS: Perfusate samples collected from clinical EVLP cases performed from 2009 to 2019 were separated into development (n = 281) and validation (n = 57) sets to derive and validate an inflammation score based on IL-6 and IL-8 protein levels in perfusate. The ability of an inflammation score to predict lungs suitable for transplantation and likely to produce excellent recipient outcomes (time on ventilator ≤ 3 days) was assessed. Inflammation scores were compared to conventional clinical EVLP assessment parameters and associated with outcomes, including primary graft dysfunction and patient care in the ICU. RESULTS: An inflammation score accurately predicted the decision to transplant (AUROC 68% [95% CI 62-74]) at the end of EVLP and those transplants associated with short ventilator times (AUROC 73% [95% CI 66-80]). The score identified lungs more likely to develop primary graft dysfunction at 72-hours post-transplant (OR 4.0, p = 0.03). A model comprised of the inflammation score and ∆PO2 was able to determine EVLP transplants that were likely to have excellent recipient outcomes, with an accuracy of 87% [95% CI 83-92]. CONCLUSIONS: The adoption of an inflammation score will improve accuracy of EVLP decision-making and increase confidence of surgical teams to determine lungs that are suitable for transplantation, thereby improving organ utilization rates and patient outcomes.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Donantes de Tejidos / Trasplante de Pulmón / Circulación Extracorporea / Lesión Pulmonar / Disfunción Primaria del Injerto / Inflamación Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Heart Lung Transplant Asunto de la revista: CARDIOLOGIA / TRANSPLANTE Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Donantes de Tejidos / Trasplante de Pulmón / Circulación Extracorporea / Lesión Pulmonar / Disfunción Primaria del Injerto / Inflamación Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Heart Lung Transplant Asunto de la revista: CARDIOLOGIA / TRANSPLANTE Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos