Study on HOPE Technique Promising for Safe Lung Preservation Before Transplantation
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A study titled "Evaluation of Hypothermic Oxygenated Machine Perfusion (HOPE) for Lung Preservation" has demonstrated that the hypothermic oxygenated machine perfusion (HOPE) technique is a safe and effective method for preserving donor lungs, even with total out-of-body times nearing 20 hours. The study, presented by Jitte Jennekens, MSc, organ perfusionist/transplant coordinator at UMC Utrecht in the Netherlands, was unveiled at the International Society of Heart and Lung Transplantation (ISHLT) Annual Meeting in Boston.
"This technique has been used for preserving livers and kidneys and is undergoing trials for hearts, but it hasn't been widely studied for lung preservation," said Jennekens.
Ex vivo lung perfusion (EVLP) is an established method that allows donor lungs to be preserved and evaluated outside the body before transplantation. The lungs are connected to a pump and ventilator, perfused with a physiological fluid, and sometimes reconditioned. Typically, donor lungs are transported on ice, then warmed to 37°C for functional testing using normothermic EVLP (nEVLP), before being returned to ice until transplantation.
The UMC Utrecht’s HOPE protocol improves upon this process by eliminating the second cooling phase. After an hour of nEVLP, lungs are maintained at 12°C until transplantation. In a comparison of 12 cases using the nEVLP-HOPE protocol with 118 historical cases of direct lung transplantation without perfusion, no lungs in the HOPE group were rejected. Short-term outcomes were comparable between the two groups.
“Our results confirm that HOPE is a safe and effective preservation method following normothermic EVLP,” Jennekens said. The next step, according to Jennekens, is determining which preservation strategy works best for specific types of donor lungs, paving the way for future optimization of donor lungs with targeted therapies.
References: Park, Chanmin; Ko, Yong Jae; Kim, Hee Youn; Sagas, Michael; Eddosary, Melfy, Social Behavior and Personality: an international journal, 2016
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