Ex Vivo Lung Perfusion with manual method
System Set-up for manual method
EVLP with STEEN Solution™ is a method to assess viability of donated lungs. EVLP expand the potential donor pool, by increasing the time for the clinician to access the lungs in a near physiologic environment.
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 allows fine targeted of organ temperature, left atrial pressure, pulmonary arterial pressure, venous PaO2 and PaCO2. Which are targeted in a protocolized manner.
Included in the circuit, the heat exchanger and oxygenator is connected to the pulmonary artery of the lung to allow the perfusate to assume the temperature and partial gas pressures of normal venous blood. A leucocyte filter is connect to remove circulating leucocytes from the circuit and the lung. Blood gases are being sampled at the venous and arterial side of the lung(s) to monitor gas exchange. A standard ventilator is connected via an endotracheal tube secured in the trachea. The lungs are placed in the XVIVO Organ Chamber™, a chamber devised to maintain humidity.
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 perfusion and promote stability of isolated lungs ex vivo.
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
- Vital signs monitor
- Gas analyser (either online or by solution sampling)
- Cylinder with O2 100% and Cylinder of CO2 7% – N2 93% (Lund method)
- Cylinder containing O2 6%, CO2 8% and N2 86% (Toronto method)