Transplant Trial Watch

Prone ex vivo lung perfusion protects human lungs from reperfusion injury.

Niikawa, H., et al.

Artificial Organs 2022 [record in progress].

This study aimed to assess whether prone positioning during EVLP was advantageous in human donor lungs declined for clinical transplant.

Human double lung blocs were randomly assigned to either prone ex vivo lung perfusion (EVLP) or supine EVLP.

10 human double lung blocs rejected for clinical transplant.

Lung function, compliance, weight and transplant suitability.

Following 2 hours of EVLP.

CET Conclusions
The small experimental study randomised 10 double-lung blocks declined for transplant to either prone ex-vivo perfusion (EVLP) or supine EVLP. EVLP was continued for 2 hours, following which lung function, compliance and weight were assessed ex-vivo. The authors report that function was improved, and weight lower, in the prone group, with 3/5 lung blocks deemed suitable for transplant compared to none in the supine group. These findings are very interesting, but there are of course some limitations. Declined organs are likely to have different characteristics and a greater degree of variability in quality than those utilised for transplant, and in such a small sample there is the possibility of a type 1 error. As none of the lungs were transplanted, it is not clear whether the improvement in ex-vivo assessment would translate to improved clinical outcomes. However, the results do support further evaluation of prone EVLP in clinical studies of lungs intended for transplantation.

Jadad score

Data analysis
Per protocol analysis

Allocation concealment

Trial registration

Funding source
No funding received