STEEN solution permits ex-vivo lung perfusion (EVLP) for 24 hours
A German study confirms previous findings that prolonged warm EVLP with STEEN perfusate is quite feasible for at least 24 hours.
Prolonged normothermic ex-vivo lung perfusion (EVLP) has become an invaluable procedure for reconditioning suboptimal donor lungs. Most centers run EVLP for up to 12 hours but some forms of therapeutic reconditioning ideally require ex-vivo perfusion for much longer periods.
We previously reported successful maintenance of warm EVLP for up to 24 hours at Toronto using continuously replenished acellular STEEN solution as perfusate (Takahashi et al, 2018)(8)</sup). Similar success was recently reported from Hannover too, also in a porcine lung model (Sommer W et al, 2018)(9).
The Hannover group compared three perfusates: STEEN solution with red blood cells enriched with erythrocytes, acellular STEEN solution (without erythrocytes) and low-potassium dextran (LPD) enriched with erythrocytes. After 24 hours EVLP, the left lung was transplanted into recipient pigs and observed for six hours. The most favourable outcome was observed in organs utilizing STEEN solution + red cells as perfusate, (contrary to the Toronto group who used acellular STEEN). Sommer et al also found that PAWP and PVR during EVLP are early and late predictors of transplant outcome, respectively.