Manual method

System Set-up for manual method

EVLP with STEEN Solution™ is a method to assess lung viability of donated lungs. EVLP aims to expand the potential donor pool, by providing a near physiologic environment ultimately leading to decreased inflammation and rejection.

In order to evaluate an organ in an ex vivo system the STEEN Solution™ must be circulated through the organ via an extracorporeal perfusion circuit that allows continuous flow of nutrients and gas at a rate set by the clinician.

The circuit (see figure 1) allows fine control of organ temperature, left atrial pressure, pulmonary arterial pressure, venous PaO2and PaCO2, which are targeted in a protocolised manner.

A heat exchanger is connected to the “venous” afferent side of the circuit to allow the perfusate to assume the temperature and partial gas pressures of normal venous blood. A leucocyte filter is connected to prevent recirculation into the circuit and the lung. A membrane de-oxygenator is employed with both pre- and post- “membrane exchanger” gases being continuously monitored; membrane gas flow varies according to phase of evaluation and technique employed. A standard ventilator is connected via an endotracheal tube secured in the trachea. The lungs are placed in the XVIVO Organ Chamber™, a dome devised to maintain humidity.

STEEN SOLUTION™

STEEN Solution™

The STEEN Solution™ is a buffered extracellular solution that includes human albumin to provide an optimal colloid osmotic pressure and dextran 40 to coat and protect the endothelium from excessive leucocyte interaction.

STEEN Solution™ is designed to facilitate prolonged evaluation and promote stability of isolated lungs ex vivo.

STEEN SOLUTION™

Hardware requirements

Hardware requirements for an EVLP procedure are generally off-the-shelf standard cardiac bypass equipment and include the following items:

  • Centrifugal Pump and flow sensor
  • Heater-cooler unit
  • Ventilator
  • Vital signs monitor
  • Gas analyser (either online or by solution sampling)
  • Cylinder with O2 100% and Cylinder of CO2 7% – N 93% (Lund method)
  • Cylinder containing O2 6%, CO2 8% and N2 86% (Toronto method)

Disposables needed for manual method

Disposables needed for an EVLP procedure using the manual method include:

  • XVIVO Organ Chamber™
  • XVIVO Lung Cannula Set™ (Arterial and Venous cannulae)
  • Reservoir
  • Heater exchanger
  • Oxygenator membrane
  • Centrifugal pump head
  • Leukocyte filter

Are you setting up a clinical program or interested to learn more about EVLP?

Contact us and we will assist you in your process