High risk lungs are safe for transplant and can expand donor pool

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High-risk donor lungs that have been kept alive outside the body have just as good long-term outcomes as conventional donor lungs, according to a Canadian study. This technique, known as ex vivo lung perfusion, meant the centre providing the transplants had access to a wider pool of donor lungs, so could significantly increase the total number of transplants performed during the study period. Since lots of patients die waiting for lung transplants, or become too sick to even undergo the procedure, any increase in the donor lung pool can have a huge impact, the authors say. An accompanying editorial notes that earlier studies had shown positive signs for patients post-surgery, but this 10-year follow up study is the first to look at longer-term outcomes.

Journal/conference: JAMA Surgery

DOI: 10.1001/jamasurg.2019.4079

Organisation/s: Toronto General Hospital, Canada

Funder: Dr Cypel reported receiving personal fees from Lung Bioengeneering; and receiving funding from XOR Labs Toronto and Perfusix Canada outside the submitted work. Dr Waddell reported receiving grants from Canadian Institutes of Health Research and nonfinancial support from Xenios/Fresenius during the conduct of the study. Dr de Perrot reported receiving personal fees from Bayer outside the submitted work. Dr Keshavjee reported receiving research funding from Perfusix Canada and XOR Labs Toronto; receiving grants from United Therapeutics outside the submitted work; and having a patent to XOR Lung Perfusion pending. Dr Tikkanen reported receiving nonfinancial support from Perfusix Canada during the conduct of the study; and personal fees from CSL Behring and Boehringer-Ingelheim outside the submitted work. Drs Cypel, Waddell, and Keshavjee are founders of Perfusix Canada, which provides ex vivo lung perfusion (EVLP) services to University Health Network. Owing to conflict of interest relative to EVLP activities as lung transplant surgeons in the institution, Drs Cypel, Waddell, and Keshavjee do not receive any payments from Perfusix Canada. Perfusix Canada is a nonprofit company that does not generate profit from EVLP activities provided for University Health Network patients. Drs Cypel, Waddell, and Keshavjee are also founders of XOR Labs Toronto, a company dedicated to development of EVLP machines. The XOR Labs Toronto EVLP machine is in development phase and was not used in the performance of this study. Lung Bioengineering acquired Perfusix USA in 2015, a company that was cofounded by Drs Cypel, Waddell, and Keshavjee. Currently, Drs Cypel, Waddell, and Keshavjee are paid consultants for Lung Bioengineering. They give strategic advice to Lung Bioengineering lung perfusion center as members of its Scientific Advisory Board.


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