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Vol. 60. Issue 6.
Pages 336-343 (June 2024)
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Vol. 60. Issue 6.
Pages 336-343 (June 2024)
Original Article
Donor Lung Preservation at 10°C: Clinical and Logistical Impact
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Mariana Gil Barturena, Rosalía Laporta Hernándezb, Antonio Romero Berrocalc, Marina Pérez Redondod, Natalia Gómez Lozanoe, Javier Martín Lópezf, Ana Royuela Vicenteg, Alejandra Romero Romána, Lucas Hoyos Mejíaa, Silvana Crowley Carrascoa, David Gómez de Antonioa, Jose Manuel Naranjo Gómeza, Mar Córdoba Peláeza, Nuria María Novoaa, Jose Luis Campo-Cañaveral de la Cruza,h,
Corresponding author
jluiscampo82@gmail.com

Corresponding author.
a Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
b Pneumology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
c Anesthesiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
d Transplant Coordination and Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
e Immunology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
f Pathology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
g Biostatistics Unit; Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain
h Universidad Europea de Madrid, Department of Medicine, Spain
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Figures (7)
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Tables (2)
Table 1. Demographics and transplant outcomes comparing prolonged preservation at 10°C vs. standard preservation on ice.
Table 2. Cytokine expression profile comparing both preservation methods.
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Additional material (1)
Abstract
Introduction

Cold static donor lung preservation at 10°C appears to be a promising method to safely extend the cold ischemic time (CIT) and improve lung transplant (LTx) logistics.

Methods

LTx from November 2021 to February 2023 were included in this single institution, prospective, non-randomized study comparing prolonged preservation at 10°C versus standard preservation on ice. The inclusion criteria for 10°C preservation were suitable grafts for LTx without any donor retrieval concerns. Primary endpoint: primary graft dysfunction (PGD) grade-3 at 72-h. Secondary endpoints: clinical outcomes, cytokine profile and logistical impact.

Results

Thirty-three out of fifty-seven cases were preserved at 10°C. Donor and recipient characteristics were similar across the groups. Total preservation times (h:min) were longer (p<0.001) in the 10°C group [1st lung: median 12:09 (IQR 9:23–13:29); 2nd: 14:24 (12:00–16:20)] vs. standard group [1st lung: median 5:47 (IQR 5:18–6:40); 2nd: 7:15 (6:33–7:40)]. PGD grade-3 at 72-h was 9.4% in 10°C group vs. 12.5% in standard group (p=0.440). Length of mechanical ventilation (MV), ICU and hospital stays were similar in both groups. Thirty and ninety-day mortality rates were 0% in 10°C group (vs. 4.2% in standard group). IL-8 concentration was significantly higher 6-h post-LTx in the standard group (p=0.025) and IL-10 concentration was increased 72-h post-LTx in the 10°C group (p=0.045).

Conclusions

Preservation at 10°C may represent a safe and feasible strategy to intentionally prolong the CIT. In our center, extending the CIT at 10°C may allow for semi-elective LTx and improve logistics with similar outcomes compared to the current standard preservation on ice.

Keywords:
Lung transplantation
Donor lung preservation
10°C cold storage
Cytokines
Logistics
Prolonged static cold preservation
Abbreviations:
LTx
CIT
PGD
ICU
EVLP
MV
ALI
P/F ratio
ECMO
LAS
OR
IQR
ISHLT

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