Prolonged Preservation of up to 24 Hours at 10 °C Does Not Impact Outcomes after Lung Transplantation

Abstract

OBJECTIVE: To determine the impact of prolonged storage of donor lungs at 10 °C for up to 24 hours on outcome after lung transplantation. BACKGROUND: An increasing body of evidence suggests 10 °C as the optimal storage temperature for donor lungs. A recent study showed that cold ischemic times can be safely expanded to >12 hours when lungs are stored at 10 °C. However, it is currently unknown how long donor lungs can be preserved before they deteriorate in function. METHODS: Patients who received a donor lung stored at 10 °C between November 2020 and June 2023 at the lung transplant programs of Toronto, Vienna, and Madrid were included in this retrospective analysis. After excluding ex-vivo lung perfusion cases, recipients were grouped based on the total preservation times of their donor organs (<12 hours: n = 48; 12-18 hours: n = 109; ≥18 hours: n = 24). Three hundred seventy-two recipients who had received an organ stored on-ice during the study period served as a control group. RESULTS: Length of lung preservation ranged from 2 hours 27 minutes to 29 hours 33 minutes (mean: 14 hours 06 minutes). Despite these prolonged preservation times, early postoperative outcomes were excellent. Median length of mechanical ventilation did not differ among the 3 study groups [<12 hours: 41 hours (interquartile range: 24-109); 12-18 hours: 56 hours (interquartile range: 24-143) and ≥18 hours: 59 hours (interquartile range: 28-108); P = 0.493]. Intensive care unit length of stay [6 days (4-14); 8 days (4-23); 8 days (5-32)] and hospital length of stay [32 days (20-48); 29 days (20-50); 26 days (17-50)] were also similar. Furthermore, the length of donor organ preservation had no impact on patient survival (log-rank P = 0.413). CONCLUSIONS: Prolonged static preservation of donor lungs at 10 °C for up to 24 hours is safe and does not impair short-intermediate outcomes after lung transplantation.

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