*Purpose: Ex vivo lung perfusion (EVLP) has successfully been applied to the management of marginal donor lungs, while the high cost and equipment lacking restrict the promotion in China. As continuous renal replacement therapy (CRRT) is recommended for removing excess fluid, harmful chemicals, and cytokines, we hypothesis the positive value in pre-retrieval management of marginal donor lungs.

*Methods: A retrospective study with a total of 30 lung donors conducted from Jan. 1st 2019 to Oct. 31st 2019. 12 of which were marginal donors and treated with CRRT combining with routine management for 48 hours, they were set as the Intervention Group (IG); another 18 were set as the Control Group (CG) and treated with routine management. Peripheral arterial and venous blood samples were collected every 12 hours. Chest radiography and tracheal fibro-bronchoscope from both groups were checked before and after the duration, and the oxygenation index, inflammatory indexes (PCT and CRP) were analyzed.

*Results: Both groups were comparable at baseline. The average levels of oxygenation index (OI) showed an increasing trend with time, while the inflammatory indexes showed a declining trend. Compared with the CG, IG showed a significant increase range (93.58±16.92 vs. 57.72±11.41, p<0.001), a significantly decline range of CRP (36.04±22.30 vs. 18.01±6.78, p=0.018) and PCT (1.09±0.45 vs. 0.59±0.82, p=0.028). In addition, significant improvements of pulmonary edema in chest radiography and reduced airway edema confirmed in the fibro-bronchoscope before and after the duration. Finally, 8 of 12 cases in IG and 5 of 18 in CG reached the acceptant donor lung criteria, revealing a significant difference in the overall use ratio between the two groups (p=0.035).

*Conclusions: In the pre-retrieval management of donor lung, an intensive pattern of CRRT combined with routine management would be a more effective strategy, especially in potential marginal criteria donors.

« Back to 2020 American Transplant Congress