Our Summary

This research paper discusses different methods used to store human lungs for transplantation. Currently, the most common method is cold storage, which is simple and cost-effective, but it has some limitations. For example, it doesn’t offer much flexibility and it can’t prevent certain types of damage to the lungs.

The paper also discusses newer methods of lung storage, such as devices that keep lungs alive by pumping them with blood and air outside the body, a process known as ex vivo lung perfusion (EVLP). Examples of these devices include TransMedics OCS and XVIVO perfusion systems. These devices not only help to preserve the lungs for a longer period, but they also allow doctors to test the lungs to see if they’re suitable for transplant.

While these new devices are more expensive and require more resources and staff to operate, they have many advantages. They can extend the time lungs can be preserved, allow for better assessment of the lungs’ condition, reduce the risk of certain types of damage, and improve the quality of lungs that can be used for transplant.

In conclusion, although these new devices are more costly, they could potentially increase the number of successful lung transplants by allowing for better preservation and assessment of donor lungs.

FAQs

  1. What is the gold standard treatment for end stage lung disease?
  2. How do ex vivo lung perfusion (EVLP) devices like TransMedics OCS and XVIVO perfusion systems benefit lung transplantation procedures?
  3. What are the disadvantages of using EVLP devices compared to static cold storage for lung transplantation?

Doctor’s Tip

One helpful tip a doctor might give a patient about lung transplant is to be prepared for the possibility of using novel ex vivo lung perfusion (EVLP) devices such as TransMedics OCS or XVIVO perfusion systems. These devices can extend preservation time of donor lungs and allow for evaluation of lung viability, potentially improving outcomes for patients receiving extended criteria donor lungs. Patients should be aware that these devices may require additional resources and personnel support compared to traditional static cold storage, but they offer the opportunity to optimize donor lungs and mitigate ischemic-reperfusion injury.

Suitable For

Patients who are typically recommended for lung transplant include those with end stage lung disease who have failed other medical treatments. This can include conditions such as chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, cystic fibrosis, and pulmonary hypertension. Patients who have severe symptoms, poor quality of life, and a limited life expectancy without a transplant are considered for lung transplantation. Additionally, patients must be medically fit enough to undergo the transplant surgery and post-operative recovery process.

Timeline

Before lung transplant:

  1. Patient is diagnosed with end stage lung disease and is evaluated for lung transplantation.
  2. Patient undergoes extensive medical and psychological evaluations to determine eligibility for transplant.
  3. Patient is placed on the transplant waiting list and waits for a suitable donor match.
  4. Patient may experience worsening symptoms and decline in health while waiting for a transplant.
  5. Patient receives notification of a potential donor match and undergoes pre-transplant evaluations and testing.
  6. Patient undergoes lung transplant surgery.

After lung transplant:

  1. Patient is closely monitored in the intensive care unit immediately post-transplant.
  2. Patient is gradually weaned off ventilator support and other medical interventions.
  3. Patient begins physical therapy and rehabilitation to regain strength and function.
  4. Patient is started on immunosuppressive medications to prevent rejection of the transplanted lung.
  5. Patient is monitored closely for signs of rejection, infection, and other complications.
  6. Patient undergoes regular follow-up appointments and monitoring to ensure the health and function of the transplanted lung.
  7. Patient resumes normal activities and enjoys improved quality of life post-transplant.

What to Ask Your Doctor

  1. What specific criteria are used to determine if I am a candidate for a lung transplant?
  2. How long is the waiting list for a lung transplant and what factors can affect my placement on the list?
  3. What are the potential risks and complications associated with lung transplant surgery?
  4. How will my quality of life be impacted after receiving a lung transplant?
  5. What is the expected recovery time after lung transplant surgery?
  6. What medications will I need to take after the transplant and what are the potential side effects?
  7. How often will I need to follow up with my transplant team after the surgery?
  8. What lifestyle changes will I need to make after receiving a lung transplant?
  9. How long can I expect my new lung to last and are there any additional surgeries or treatments that may be needed in the future?
  10. What are the alternatives to lung transplant surgery and how do they compare in terms of effectiveness and long-term outcomes?

Reference

Authors: Bisbee CR, Sherard C, Kwon J, Hashmi ZA, Gibney BC, Rajab T. Journal: Expert Rev Med Devices. 2022 Dec;19(12):959-964. doi: 10.1080/17434440.2022.2151359. Epub 2022 Dec 6. PMID: 36444725