EMBARGOED UNTIL 10:10AM, May 16, 2022
Newswise — Boston, MA (May 16, 2022) - A study presented today at the AATS 102nd Annual Meeting reports that intentionally prolonging the cold static preservation (CSP) of a donor lung at 10°C (12-24h) is clinically safe and feasible. The mechanisms of the benefits are various, but mainly pertain to better mitochondrial preservation at that temperature.
Pre-clinical studies that demonstrated the safety of preserving lungs up to as much as 36h led to the design of this prospective multicenter clinical trial. The trial was designed to investigate the feasibility of intentionally prolonging CSP at 10°C to avoid overnight (10PM-6AM) transplants. During the trial, all lung transplants that would begin at night (after 8PM) were scheduled for the morning (6AM or later).
The study looked at primary graft disfunction (PGD), recipient time on a ventilator, ICU and hospital length-of-stay, 30-day survival, and lung function at one year. Lungs needing ex vivo lung perfusion (EVLP) were excluded from the study. The outcomes were compared with a contemporaneous cohort of recipients at each center who had received transplants maintained at 4°C. The PGD at 72h was 3% in the study group and 11% in matched controls, one indicator of the safety of CSP.
Moving night transplants to the morning has many advantages. Data from emergency surgery show that procedures done during the day have better outcomes. Rested surgeons, anesthetists, and nurses perform better; and more help is available at the hospital in the case of intraoperative complications.
Longer CSP can improve transplant logistics. In the case of multiple donors at the same time, the ability to safely delay transplantation for some can accommodate available OR resources.
Marcelo Cypel, MD, Surgical Director of the Ajmera Transplant Centre, University Health Network, University of Toronto, reports that “based on our results, we were indeed able to confirm that patients receiving these lungs had excellent outcomes, and in fact, did better compared to matched controls that underwent lung transplantation in the usual fashion.”
“This will also likely change the gold standard of lung preservation from ice cooler at 4°C to 10°C,” says Dr. Cypel.
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Presented by Marcelo Cypel, MD, May 16, 2022, at the AATS 102nd Annual Meeting
ABOUT THE AMERICAN ASSOCIATION FOR THORACIC SURGERY (AATS)
The American Association for Thoracic Surgery (AATS) is an international organization that encourages, promotes, and stimulates the scientific investigation of cardiothoracic surgery. Founded in 1917 by a respected group of the earliest pioneers in the field, its original mission was to “foster the evolution of an interest in surgery of the Thorax.” Today, the AATS is the premiere association for cardiothoracic surgeons in the world and works to continually enhance the ability of cardiothoracic surgeons to provide the highest quality of patient care. Its more than 1,500 members have a proven record of distinction within the specialty and have made significant contributions to the care and treatment of cardiothoracic disease. Visit www.aats.org to learn more.
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