A novel concept for evaluation of pulmonary function utilizing PaO2/FiO2 difference at the distinctive FiO2 in cellular ex vivo lung perfusion—an experimental study

Hiromichi Niikawa, Toshihiro Okamoto, Kamal S. Ayyat, Yoshifumi Itoda, Carol F. Farver, J. Steven Hata, Kenneth R. McCurry

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

For more accurate lung evaluation in ex vivo lung perfusion (EVLP), we have devised a new parameter, PaO2/FiO2 ratio difference (PFD); PFD1–0.4 = P/F ratio at FiO2 1.0 - P/F ratio at FiO2 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, PFD1–0.4 was compared with transplant suitability and physiological parameters. In a second study, 10 pig lungs were perfused in same fashion. PFD1–0.4 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 PFD1–0.4 had the highest area under curve, 0.90, sensitivity, 0.96, to detect nonsuitable lungs, and significant negative correlation with lung weight ratio (R2 = 0.26, P < 0.001). In pig model, PFD1–0.4 on lower and upper lobe pulmonary veins were significantly associated with corresponding lobe wet/dry ratios (R2 = 0.51, P = 0.019; R2 = 0.37, P = 0.060), respectively. PFD1–0.4 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.

Original languageEnglish
Pages (from-to)797-807
Number of pages11
JournalTransplant International
Volume32
Issue number8
DOIs
Publication statusPublished - 2019 Aug
Externally publishedYes

Keywords

  • donor lung assessment
  • ex vivo lung perfusion
  • lung lobes assessment
  • lung transplantation
  • PaO/FiO ratio
  • PaO/FiO ratio difference

ASJC Scopus subject areas

  • Transplantation

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