Standard lungs versus sub-standard EVLP-treated lungs: Updated meta-analysis confirms comparable outcomes and survival

Mid-to long-term survival rates and the likelihood of primary graft dysfunction were comparable in EVLP and standard lungs.

Although this topic has been touched upon previously, the rapidly accumulating evidence base has recently been updated by Chakos et al⁽³⁾, who compared outcomes from 407 EVLP treated sub-standard lungs with those of 1,765 standard lungs implanted at the same time.

In total, 13 publications met their criteria for meta-analysis: most donor lungs were from brain death donors (DBD), with EVLP lungs having significantly worse PaO2/FiO2 ratio and significantly greater rate of abnormal chest X-ray prior to EVLP.

Meta-analysis revealed no significant difference in mid- to long-term (12–36 month) survival of EVLP lung transplant patients when compared to standard protocol donor lungs. The same conclusion applied to 30-day mortality and primary graft dysfunction (PGD) grade 3 at 72 hours. The authors conclude that EVLP continues to offer the potential for increased lung utilization with no cost in terms of outcomes.

References:

3. Chakos A et al, Ex-vivo lung perfusion versus standard protocol lung transplantation-mid-term survival and meta-analysis. Ann Cardiothorac Surg. 2020 Jan;9(1):1-9. (link to abstract)

Xvivo Insights PB-2020-06-31