Open AccessA novel concept for evaluation of pulmonary function utilizing PaO2/FiO2 difference at the distinctive FiO2 in cellular ex vivo lung perfusion—an experimental study
Author(s) -
Niikawa Hiromichi,
Okamoto Toshihiro,
Ayyat Kamal S.,
Itoda Yoshifumi,
Farver Carol F.,
Hata J. Steven,
McCurry Kenneth R.
Publication year - 2019
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13426
Subject(s) - medicine , lung , perfusion , receiver operating characteristic , ex vivo , lung transplantation , lobe , pulmonary edema , area under the curve , nuclear medicine , in vivo , cardiology , pathology , biology , microbiology and biotechnology
Summary For more accurate lung evaluation in ex vivo lung perfusion ( EVLP ), we have devised a new parameter, PaO 2 /FiO 2 ratio difference ( PFD ); PFD 1–0.4 = P/F ratio at FiO 2 1.0 ‐ P/F ratio at FiO 2 0.4. The aim of this study is to compare PFD and transplant suitability, and physiological parameters utilized in cellular EVLP . Thirty‐nine human donor lungs were perfused. At 2 h of EVLP , PFD 1–0.4 was compared with transplant suitability and physiological parameters. In a second study, 10 pig lungs were perfused in same fashion. PFD 1–0.4 was calculated by blood from upper and lower lobe pulmonary veins and compared with lobe wet/dry ratio and pathological findings. In human model, receiver operating characteristic curve analysis showed PFD 1–0.4 had the highest area under curve, 0.90, sensitivity, 0.96, to detect nonsuitable lungs, and significant negative correlation with lung weight ratio ( R 2 = 0.26, P < 0.001). In pig model, PFD 1–0.4 on lower and upper lobe pulmonary veins were significantly associated with corresponding lobe wet/dry ratios ( R 2 = 0.51, P = 0.019; R 2 = 0.37, P = 0.060), respectively. PFD 1–0.4 in EVLP demonstrated a significant correlation with lung weight ratio and allowed more precise assessment of individual lobes in detecting lung edema. Moreover, it might support decision‐making in evaluation with current EVLP criteria.