A perfusionist’s role in lung transplant preservation

Abstract

The major obstacles of organ transplantation are the shortage of available organs from donors and the limited time an organ remains viable. The scarcity of organs has increased the importance of effective preservation technology. The optimal lung preservation techniques are controversial and in a state of evolution. Recent areas of research include the ideal perfusate solution, the benefit of different pharmacological additives and the best techniques for organ preservation. Our technique for lung preservation has yielded highly successful results. The perfusionist delivers 4-5 L of modified Euro-Collins solution and 500 mg of prostaglandin E1 through a circuit. The designed circuit allows the perfusate to be delivered cold and at a pressure less than 40 mmHg via the use of a manually operated centrifugal pump. Results: In 2002, the operative mortality for all lung transplants was 2.7%. One-year and two-year survival for recipients was 79% and 68% respectively; the national average for one-year survival was around 77% with a 9% mortality. As organ transplant surgery continues to grow, effective organ preservation techniques and technology will expand as well.