(1236) Moderately Prolonged Cold Ischemic Time. Does It Impact Outcome of Lung Transplantation

• Published in: The Journal of heart and lung transplantation Vol. 42; no. 4; pp. S527 - S528
• Main Authors: Ahmed, H., Saez, D. Garcia, Zych, B., Dunning, J., Khoshbin, E.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2023
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2023.02.1446

According to the international literature a total lung cold ischemic time of less than 6 hours is associated with best outcome of lung transplantation. However, allowing longer total cold ischemic times may lead to expansion of the donor pool and potentially increase transplant numbers. We examined the effect of moderately prolonged cold ischemic time (> 8 hour) on outcome of our lung transplant recipients. We reviewed all patients that underwent lung transplantation between 2013 and 2017. After the exclusion of patients with pre-operative extracorporeal membrane oxygenation (ECMO), mechanical ventilation, donor lung ex-vivo perfusion and single lung transplantation, 158 patients following routine single sequential (bilateral) lung transplantation were studied. Patients were divided into two groups, A (n=81) with cold ischemic time < 8 hours for both lungs and group B (n = 77) > 8 up to 11 hours. There was no significant difference in age, gender, preoperative echo findings and diagnosis between groups. In groups A and B, postoperative need for ECMO was 8.6% versus 7.6 % respectively, p=0.86. Duration of ventilation in groups A and B were 209.4±279.0 and 246.4±420.0 hours, p=0.52. Reintubation rate was 18.5% vs. 26.0% respectively, p=0.17, and length of ITU stay, 12.4±17.1 vs. 18.2±20.0 days, p=0.08, respectively. They were not significantly different. 1, 3- and 5-year survival were also similar: 88.9 % vs 87.0%, 77.8 % vs 76.4% and 73.3% vs 71.1% respectively p= 0.98. Moderately prolonged lung allograft cold ischemic time of up to 11 hours does not impair short- and medium-term outcomes of lung transplantation, however, may allow utilization of organs further afield. Studies are required to assess improvement in organ utilization by adapting this practice.