In situ lung perfusion is a valuable tool to assess lungs from donation after circulatory death donors category I-II

Transpl Int. 2013 May;26(5):485-92. doi: 10.1111/tri.12068. Epub 2013 Feb 6.


Donations after circulatory death (DCD) lung grafts are an alternative to extend the donor pool in lung transplantation. This study investigates the use of an in situ lung perfusion system (ISLP) in the donor to evaluate category I-II lungs. Pigs were sacrificed by ventricular fibrillation. All animals underwent 20 min of cardiopulmonary resuscitation and 5 min hands-off period after which heparin was administered. In group [WI-1], this was followed by 1 h of warm ischemia (WI) and 2 h of topical cooling (TC). In group [WI-2], 2 h of WI was followed by 1 h of TC. In group [WI-0], there was a minimal period of WI and no TC. In all three groups, the lungs were then evaluated during 60 min with ISLP. [WI-0] lungs showed a significantly higher compliance and Δ PO2 /FiO2 compared with [WI-1] and [WI-2]. PaCO2 and lactate production were higher in [WI-2] versus [WI-0]. Wet/Dry weight ratio was significantly higher in [WI-2] compared with [WI-0] in two lung biopsy locations. A high W/D weight ratio was correlated with a lower compliance, higher lactate production, and a higher PaCO2 . ISLP is an effective way to assess the quality of lungs from category I-II DCD donors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Carbon Dioxide / physiology
  • Death*
  • Lactic Acid / biosynthesis
  • Lung / pathology
  • Lung / physiology
  • Lung Compliance
  • Lung Transplantation*
  • Perfusion
  • Respiratory Function Tests / methods*
  • Sus scrofa
  • Tissue Donors*
  • Tissue and Organ Procurement
  • Warm Ischemia


  • Carbon Dioxide
  • Lactic Acid