The Journal of Heart and Lung Transplantation, Vol 35, No 4S, April 2016
in both EVLP systems at 1 hr (106.8 ± 4.1 vs. 100.7 ± 8.3 ng/ml, p < 0.54 in Swedish; 108.7 ± 1.9 vs. 75.6 ± 8.7 ng/ml, p < 0.03 in Toronto). CD81 was also higher in long cold ischemic time group (less than 8 hr) than in short cold ischemic time group (more than 8 hr) in both systems at 1 hr (105.9 ± 6.1 vs. 93.1 ± 11.3 ng/ml, p < 0.50 in Swedish; 93.2 ± 9.8 vs. 73.3 ± 18.5 ng/ml, p < 0.51 in Toronto). RT-PCR analysis demonstrated that lung specific mRNAs (SFTPA, SFTPB, and SFTPC) were detected in perfusates. The level of SFTPA was 9059 ± 3116 copy/mL at 2 hr in Swedish and 5833 ± 2461 copy/mL at 4 hr in Toronto. Beta-actin level was 18604 ± 3799 copy/mL at 2 hr in Swedish and 23857 ± 5407 copy/mL at 4 hr in Toronto. Conclusion: Lung-specific exosomes containing mRNA of surfactant were detected in perfusates of EVLP. CD81 at 1 hr may be a biomarker of lung injury in EVLP.
CONV groups, respectively (log rank, p= 0.37). Lung function test showed a mean FEV1% of 76% and 79% at 1 year in the EVLP and CONV groups, respectively (p= ns). Lung function continued to show no difference between groups at 2 years of follow-up. Conclusion: At our two centres, time in ICU (and other clinical parameters not shown in abstract) was not different between groups. In addition, shortterm survival up towards 2 years as well as pulmonary function in patients transplanted with lungs evaluated with EVLP seem non-inferior to patients transplanted with conventional donor lungs.
Lung Transplantation after Ex-Vivo Lung Perfusion in Two Scandinavian Centres T. Nilsson ,1 M. Zemtsovski,2 A. Wallinder,3 I. Henriksson,2 S. Ricksten,1 H. Møller-Sørensen,2 G.C. Riise,4 M. Perch,5 M. Iversen,5 G. Dellgren.6 1Cardiothoracic Anaesthesia and Intensive Care, Sahlgrenska Univ Hospital, Goteborg, Sweden; 2Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen, Denmark; 3Cardiothoracic Surgery, Sahlgrenska Univ Hospital, Goteborg, Sweden; 4Transplant Institute, Sahlgrenska Univ Hospital, Goteborg, Sweden; 5Lung Transplant Unit, Rigshospitalet, Copenhagen, Denmark; 6Sahlgrenska Univ Hospital, Goteborg, Sweden.
Carbapenem-Resistant Klebsiella Pneumoniae in Lung Transplantation Recipients L. Morlacchi ,1 V. Rossetti,1 P. Tarsia,1 C. Travierso,1 L. Rosso,2 M. Nosotti,2 F. Blasi.1 1Department of Pathophysiology and Transplantation, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico di Milano; Università degli Studi di Milano, Milano, Italy; 2U.O. Chirurgia Toracica e dei Trapianti di Polmone, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico di Milano; Università degli Studi di Milano, Milano, Italy.
Purpose: Ex vivo lung perfusion (EVLP) is adopted by an increasing number of centres as a means of increasing the numbers of organs available for lung transplantation (LTx). We reviewed our combined clinical long-term outcome in patients transplanted with EVLP lungs and compared it to contemporary controls. Methods: Marginal lungs not fulfilling standard criteria for donation, but with potential for improvement, underwent EVLP between 2011 and 2015, and were transplanted if predefined criteria were met in both centres. We have identical acceptance criteria for EVLP, identical protocol, and similar EVLP device in both centres. Clinical outcome was assessed and compared to a control group of all contemporary patients transplanted with conventional donor lungs (CONV). Results: Fifty-one recipients from the regular waiting list underwent either bilateral lobar (n= 1), single (n= 6) or double (n= 44) LTx with EVLP lungs. Data was compared to a control group of (n= 258) consecutive recipients transplanted with conventional donor lungs during the same time period. Preoperative diagnoses were similar between EVLP and CONV groups. Mean ICU length of stay was 9.3 days (range, 1-65) in the EVLP group and 8.3 days (range, 1-156) (p= ns) in the CONV group. The one-year survival rate was 89.5% (CI 76.5-95.5%) and 83.7% (CI 78.3-87.9%) in the EVLP and
Purpose: The acquisition of Klebsiella pneumoniae carbapemenase producing (KPC) strains has been associated with reduced survival among lung transplant (LuTx) recipients (Raviv Y, Clin Transpl 2012). This case series present the clinical characteristics of KPC infection in LuTx patients at our institution. Methods: This study was a retrospective case-series of lung transplantation recipients who were infected with KPC strains. Data regarding transplant, clinical presentation, treatment and outcome were collected and analyzed. Diagnosis of KCP was based on specific microbiological cultures. Results: KCP infection was diagnosed in 6 patients out of 47 that underwent lung transplant from January 2014 to September 2015. Their histories are depicted in tables 1 and 2. The majority of patients acquired KPC in the post-operative period; each patient had a prolonged (> 30 days) in-hospital stay after the surgery due to difficult respiratory weaning. Conclusion: KPC acquisition is certainly a great concern among lung transplant recipients; however our data showed that mortality related to KPC colonization was relatively low. As previously reported, prolonged hospitalization, particularly ICU-stay, seems to be a very important risk factor for such an infection, as well as malnourishment. Finally, these cases may be useful to draw the physician’s attention to early and quick diagnosis in order to enable immediate isolation of infected persons to prevent further spread.