Study visit at The Bridge - Lungs for life
- lisafalk77
- Mar 16
- 2 min read
A study visit was organized by Bridge - Lungs for life on March 7 in Copenhagen, with the aim of spreading information about the project and its important work.
Summary of the study visit
Opening and introduction of the day Michael Perch
Brief introduction of everybody and EVLP experience
Introduction to the program of the day
Presentation on EVLP by Hasse Møller-Sørensen
EVLP has been used to evaluate and optimize marginal donor lungs in RH since 2012
84/101 lungs on EVLP accepted for LTx in RH (acceptance rate 83%)
Primarily lungs being marginal due to poor oxygenation or lung contusion are considered for EVLP. Future perspectives include the use of EVLP on lungs with severe infections or with a tumor suspect infiltrate
RH only center within Scandinavia using EVLP. Collaboration with Lund
Hope of expanding the collaboration to more centers within Scandiatransplant increased pool of donor lungs, increased quality of EVLP, increased cost-benefit ratio
No recommendation of small-center EVLP
Other potential future benefits of EVLP
Possibility of postponing LTx to daytime
New promising treatment modalities of donor lungs before Tx decreased risk of PGD, improvement of immune compatibility
Session about the road to LTx at the different sites represented
In most centers the Tx coordinators consult with the thoracic surgeons, who make the decision of whether the potential donor lungs are suitable for LTx or not
Many sites experience significant individual differences in acceptance/rejection within the group of surgeons
Some sites are more prone to offer potential marginal lungs to other Tx sites if rejected at their own site
Only Lund and RH are having regular audits on the rejected lungs
No DCD lungs have been exchanged within Scandiatransplant
Quite significant differences between the various sites on which lungs are accepted or not (age, aspiration, atelectasis, infections, smoking status, etc.)
Presentation on research related to EVLP by Franziska Olm
Many experiments on various treatment models in porcine (MSC, mitochondria, targets in extracellular matrix)
Hope of clinical trials as part of the Bridge project
Questions/debate/considerations
Need for a uniformed framework for both standardized lungs and extended criteria lungs in Scandinavia still allowing for local add-ons
Updated allocation criteria (Rotalist) for extended criteria lungs; should marginal lungs used for EVLP also count in this regard?
Need for internal reevaluation of acceptance/rejection criteria at each LTx center
Should all organs be offered through Scandiatransplant if rejected locally?
Would it be possible to bring the EVLP machine, team and consumables to the different Tx sites instead of them coming to RH?
Possibility of having an EVLP machine at each Tx center and then RH can assist locally with personnel and consumables?
Need for local organ retrieval teams?
Wish for a better balance between lungs given and lungs received
Wish that all Tx centers could be offered the use of EVLP in the hope of increasing the overall pool of lungs
