An interesting and exciting study has recently been published in The Lancet by Warnecke et al describing the use of a portable perfusion unit for lung preservation. The “OCS Lung” (TransMedics, Andover MA) is a mobile and stand-alone unit that can be used to perfuse donor lungs from the start of the preservation period, minimizing cold iscaemic time. Lungs were attached to the machine via pulmonary artery and trachea for a mean of 303 minutes. The perfusate used was Steen’s solution supplemented with cross-matched red cells. Functional assessment is carried out by monitoring of the oxygenation capacity of the preserved lungs.
Five of the 12 donors for this pilot case series were extended criteria donors and bilateral lung transplantation was done in all patients. The study was primarily conducted to assess the feasibility of using the OCS Lung in a “real-life” scenario, hence the majority of donors were standard criteria. It was not a reconditioning study for marginal organs. Early and mid-term outcomes were good. Interestingly, for several pairs of lungs the PaO2:FiO2 ratio increased during the preservation period which suggests that some reconditioning prior to implantation may be possible.
The favourable outcomes in this study have paved the way for an international, multicentre RCT of the OCS Lung, to compare it to standard cold preservation (NCT01630434) and I look forward to hearing more.
You can see the OCS Lung in action here.