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Clinical Transplantation of Initially Rejected Donor Lungs After Reconditioning Ex Vivo

Ingemansson, Richard, MD, PhD ; Eyjolfsson, Atli, MD ; Mared, Lena, MD ; Pierre, Leif, CCP, BSc ; Algotsson, Lars, MD, PhD ; Ekmehag, Björn, MD, PhD ; Gustafsson, Ronny, MD, PhD ; Johnsson, Per, MD, PhD ; Koul, Bansi, MD, PhD ; Lindstedt, Sandra, MD, PhD ; Lührs, Carsten, MD ; Sjöberg, Trygve, PhD ; Steen, Stig, MD, PhD

The Annals of thoracic surgery, 2009, Vol.87 (1), p.255-260 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Clinical Transplantation of Initially Rejected Donor Lungs After Reconditioning Ex Vivo
Autor: Ingemansson, Richard, MD, PhD ; Eyjolfsson, Atli, MD ; Mared, Lena, MD ; Pierre, Leif, CCP, BSc ; Algotsson, Lars, MD, PhD ; Ekmehag, Björn, MD, PhD ; Gustafsson, Ronny, MD, PhD ; Johnsson, Per, MD, PhD ; Koul, Bansi, MD, PhD ; Lindstedt, Sandra, MD, PhD ; Lührs, Carsten, MD ; Sjöberg, Trygve, PhD ; Steen, Stig, MD, PhD
Assuntos: Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac and Cardiovascular Systems ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Clinical Medicine ; Cohort Studies ; Donor Selection ; Extracorporeal Membrane Oxygenation - methods ; Female ; Follow-Up Studies ; Graft Rejection ; Graft Survival ; Humans ; Kardiologi ; Kirurgi ; Klinisk medicin ; Lung Transplantation - adverse effects ; Lung Transplantation - methods ; Male ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; Organ Preservation - methods ; Pneumology ; Reperfusion - methods ; Risk Assessment ; Sampling Studies ; Sensitivity and Specificity ; Surgery ; Survival Rate ; Tissue and Organ Procurement
É parte de: The Annals of thoracic surgery, 2009, Vol.87 (1), p.255-260
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SourceType-Scholarly Journals-1
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Descrição: Background A major problem in clinical lung transplantation is the shortage of donor lungs. Only about 20% of donor lungs are accepted for transplantation. A method to evaluate and recondition lungs ex vivo has been tested on donor lungs that have been rejected for transplantation. Methods The donor lungs were reconditioned ex vivo in an extracorporeal membrane oxygenation (ECMO) circuit with STEEN solution (Vitrolife AB, Kungsbacka, Sweden) mixed with erythrocytes. The hyperoncotic solution dehydrates edematous lung tissue. Functional evaluations were performed with deoxygenated perfusate by varying the inspired fraction of oxygen. After the reconditioning, the lungs were kept immersed at 8°C in extracorporeal membrane oxygenation until transplantation was performed. Results Six of nine initially rejected donor lungs were reconditioned to acceptable function, and in six recipients, double lung transplantation was performed. Three-month survival was 100%. One patient has since died due to sepsis after 95 days, and one due to rejection after 9 months. Four recipients are alive and well without any sign of bronchiolitis obliterans syndrome 24 months after the transplantation. Conclusions The result from the present study is promising, and we continue to transplant reconditioned lungs.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Clinical Transplantation of Initially Rejected Donor Lungs After Reconditioning Ex Vivo

New York, NY: Elsevier Inc

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