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Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection

BACKGROUND: The low acceptance rates in lung transplantation underline the importance to use every potential transplantable organ. With the use of normothermic ex vivo lung perfusion (EVLP) there is a potential to use more donor lungs for transplantation. Aim of this study was to evaluate if EVLP ha...

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Autores principales: Koch, Achim, Pizanis, Nikolaus, Bessa, Vasiliki, Slama, Alexis, Aigner, Clemens, Taube, Christian, Kamler, Markus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212143/
https://www.ncbi.nlm.nih.gov/pubmed/32395272
http://dx.doi.org/10.21037/jtd.2020.02.26
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author Koch, Achim
Pizanis, Nikolaus
Bessa, Vasiliki
Slama, Alexis
Aigner, Clemens
Taube, Christian
Kamler, Markus
author_facet Koch, Achim
Pizanis, Nikolaus
Bessa, Vasiliki
Slama, Alexis
Aigner, Clemens
Taube, Christian
Kamler, Markus
author_sort Koch, Achim
collection PubMed
description BACKGROUND: The low acceptance rates in lung transplantation underline the importance to use every potential transplantable organ. With the use of normothermic ex vivo lung perfusion (EVLP) there is a potential to use more donor lungs for transplantation. Aim of this study was to evaluate if EVLP has an effect on cytomegalovirus (CMV) infection after lung transplantation. METHODS: Between May 2016 and October 2018, 57 lung transplants were performed. Out of these 21 extended criteria lungs were evaluated by EVLP and 16 transplanted. In a retrospective study, results of EVLP treated lungs were compared with lungs after cold storage preservation (CSP). Donor/recipient CMV IgG status and seroconversion rate was examined. RESULTS: Donors were CMV IgG+ in EVLP 69% and CSP 61% (n.s.). Best pO(2) on procurement at FiO(2) 1.0 was in EVLP 278±76 versus CSP 413±96 mmHg (P≤0.05). Recipients were CMV IgG+ in EVLP 38% and CSP 63% (P<0.07). CMV seroconversion: EVLP 12%, CSP 20% (P<0.05), in the CSP group in 5% recipients with more than 1,000 copies/mL were diagnosed by PCR and treated for CMV infection. Procalcitonin (PCT) levels from day 1 to day 5 were significantly lower for CSP group (P<0.05). 30-day mortality was 12% for EVLP recipients. CONCLUSIONS: Normothermic EVLP did not influence CMV infection rate, however early PCT levels were higher in EVLP group. Short-term results were comparable to standard lung transplantation.
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spelling pubmed-72121432020-05-11 Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection Koch, Achim Pizanis, Nikolaus Bessa, Vasiliki Slama, Alexis Aigner, Clemens Taube, Christian Kamler, Markus J Thorac Dis Original Article BACKGROUND: The low acceptance rates in lung transplantation underline the importance to use every potential transplantable organ. With the use of normothermic ex vivo lung perfusion (EVLP) there is a potential to use more donor lungs for transplantation. Aim of this study was to evaluate if EVLP has an effect on cytomegalovirus (CMV) infection after lung transplantation. METHODS: Between May 2016 and October 2018, 57 lung transplants were performed. Out of these 21 extended criteria lungs were evaluated by EVLP and 16 transplanted. In a retrospective study, results of EVLP treated lungs were compared with lungs after cold storage preservation (CSP). Donor/recipient CMV IgG status and seroconversion rate was examined. RESULTS: Donors were CMV IgG+ in EVLP 69% and CSP 61% (n.s.). Best pO(2) on procurement at FiO(2) 1.0 was in EVLP 278±76 versus CSP 413±96 mmHg (P≤0.05). Recipients were CMV IgG+ in EVLP 38% and CSP 63% (P<0.07). CMV seroconversion: EVLP 12%, CSP 20% (P<0.05), in the CSP group in 5% recipients with more than 1,000 copies/mL were diagnosed by PCR and treated for CMV infection. Procalcitonin (PCT) levels from day 1 to day 5 were significantly lower for CSP group (P<0.05). 30-day mortality was 12% for EVLP recipients. CONCLUSIONS: Normothermic EVLP did not influence CMV infection rate, however early PCT levels were higher in EVLP group. Short-term results were comparable to standard lung transplantation. AME Publishing Company 2020-04 /pmc/articles/PMC7212143/ /pubmed/32395272 http://dx.doi.org/10.21037/jtd.2020.02.26 Text en 2020 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Koch, Achim
Pizanis, Nikolaus
Bessa, Vasiliki
Slama, Alexis
Aigner, Clemens
Taube, Christian
Kamler, Markus
Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection
title Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection
title_full Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection
title_fullStr Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection
title_full_unstemmed Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection
title_short Impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection
title_sort impact of normothermic ex vivo lung perfusion on early post-transplantation cytomegalovirus infection
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212143/
https://www.ncbi.nlm.nih.gov/pubmed/32395272
http://dx.doi.org/10.21037/jtd.2020.02.26
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