Purpose: The OPTN/UNOS added fields to the deceased donor registration form on 3/31/2015 to capture the intent to utilize ex vivo lung perfusion (EVLP) on a donor lung prior to transplantation (Tx). The aim is to examine the utilization of EVLP geographically in the US, and to compare early transplant outcomes between perfused (or intended to be) lungs to those lungs where perfusion was not considered.

Methods: All adult deceased donors with at least one lung recovered for Tx from 4/1/15- 6/30/17 were analyzed. The prevalence of the intended use of EVLP was examined by OPO. Post-transplant primary graft dysfunction (PGD) and 1-year recipient survival (Tx between 4/1/15-7/31/16) were compared between donors with lungs intended for EVLP vs. not intended for EVLP.

Results: For adult deceased donors (N=5,038), 9,514 lungs were recovered for the purpose of Tx in the US. EVLP was intended in 137 donors for a total of 254 lungs (20 donors of a single lung, 117 donors of double lungs) and 139 (54.7%) of EVLP donor lungs were Tx. The discard rate in the EVLP group was higher than the non-EVLP group (45.3% vs 4.2%, p<0.001). The use of EVLP varied across OPO with 20 OPOs not performing EVLP, 32 with EVLP intent for 1-10 lungs, 2 with EVLP intent for 12 lungs, and 4 with EVLP intent for >20 lungs (Figure 1). There was no significant difference in the odds of a lung with EVLP intended developing PGD grade greater than 1 compared to a lung without EVLP intended (OR 1.01, 95% CI (0.56, 1.84)). 1-yr patient survival between groups (EVLP, n=47; non-EVLP, n=2,801) was not significantly different (p= 0.686).

Conclusion: The number of donor lungs intended for EVLP prior to Tx in the US encompassed <3% of the total number of recovered donor lungs. Geographically, the use of EVLP varied greatly across OPOs. Early recipient outcomes did not differ statistically between EVLP intended donor lungs compared to conventional donation. To further understand EVLP, data collected on the transplant recipient registry form will be added in 2018 to enhance the monitoring of EVLP utilization.

CITATION INFORMATION: Lehman R., Carrico R., Uccellini K., Chan K., Whelan T. EVLP on Donor Lungs: National Trends and Outcomes Am J Transplant. 2017;17 (suppl 3).

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