Table 2.
EVLP number | Age (years)/sex | Diagnosis | High risk | Tx | CPB | Pao2/Fio2 ratio at 24 hours post-Tx (mm Hg) | PGD score at 72 hours | Post-operative ECMO | Invasive ventilation, days | ICU stay (days) | Hospital stay (days) | Survival to discharge | 1-year survival | Cause of death |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
27 | 59/M | IPF | No | Yes—DL | Yes | 378 | 0 | No | 2 | 3.5 | 46 | Yes | Yes | |
28 | 32/F | CF | NIV | Yes—DL | No | 217 | 3 | No | 1.5 | 7.5 | 21 | Yes | Yes | |
29 | 56/M | COPD | NIV | Yes—DL | Yes | 335 | 1 | Yes | 15 | 15 | 25 | Yes | No | Pneumonia |
30 | 62/F | IPF | NIV | Yes—SL | Yes | 428 (ECMO) | 3 | Yes | 65 | 65.5 | 93 | Yes | Yes | |
31 | 44/M | PAH | PAH | Yes—DL | Yes | 221 | 3 | Yes | 0.33 | 21 | 44 | Yes | Yes | |
32 | 48/M | IPF | RV↓ | Yes—DL | Yes | 286 | 1 | No | 0.5 | 1.5 | 16 | Yes | Yes | |
33 | 49/M | IPF | No | Yes—DL | Yes | 326 (ECMO) | 2 | Yes | 70 | 68 | 87 | Yes | Yes | |
34 | 59/F | COPD | No | Yes—DL | Yes | 146 | 1 | No | 1.5 | 5 | 25 | Yes | Yes | |
35 | 64/M | COPD | NIV | Yes—DL | No | 278 | 2 | No | 0.5 | 2.5 | 16 | Yes | Yes | |
36 | 20/M | CF | NIV | Yes—DL | Yes | 203 | 2 | No | 2.5 | 6.5 | 17 | Yes | Yes | |
37 | 60/M | COPD | No | Yes—DL | Yes | 345 | 1 | No | 1.5 | 5.5 | 25 | Yes | Yes | |
38 | 56/M | IPF | No | Yes—DL | Yes | 113 (ECMO) | 3 | Yes | 100a | 98 | 100a | No | No | PGDb and sepsis |
39 | 56/F | BE | No | Yes—DL | Yes | 257 | 1 | No | 3 | 14 | 31a | No | No | Pneumonia and sepsis |
40 | 56F | COPD | No | Yes—DL | Yes | 401 | 2 | No | 18a | 18a | 18a | No | No | PGDb and hypoxic brain injury |
41 | 23/M | CF | NIV + RV↓ | Yes—DL | Yes | 368 (ECMO) | 1 | Yes | 3 | 15 | 63a | No | No | PGDb and pneumonia |
42 | 58/M | IPF | NIV | Yes—SL | Yes | 71 | 3 | No | 31a | 31a | 31a | No | No | PGDb and respiratory arrest |
BE, bronchiectasis; CF, cystic fibrosis; COPD, chronic obstructive pulmonary disease; CPB, cardiopulmonary bypass; DL, double-lung; ECMO, extracorporeal membrane oxygenation; EVLP, ex vivo lung perfusion; F, female; ICU, intensive care unit; IPF, idiopathic pulmonary fibrosis; M, male; NIV, non-invasive ventilation; PAH, pulmonary artery hypertension; Pao2/Fio2, arterial oxygen partial pressure/fraction of inspired oxygen; PGD, primary graft dysfunction; RV↓, right ventricular failure; SL, single-lung; Tx, transplantation.
Death before hospital discharge.
Of 4 recipients in whom we believe PGD played a role in the cause of death, 2 had severe PGD at all time points up to 72 hours. One patient had very severe graft failure on arrival in the ICU and had to be salvaged with emergency ECMO. ECMO was weaned just before 72 hours and the patient had at this time point a saturation reflecting mild PGD, even though he never recovered and continued to need hospital treatment for failing graft function until his death at 63 days post-Tx. The fourth recipient had moderately severe PGD up to 72 hours, which never recovered. The patient was never weaned off invasive ventilation and died 18 days post-transplant.