(256) Ex-Vivo Lung Perfusion May Have a Detrimental Impact on Lung Transplants from Donation after Circulatory Death Donors

PurposeEx-vivo lung perfusion(EVLP) may allow for evaluation and rehabilitation of marginal donor lungs, including those from donation after circulatory death(DCD) donors, with outcomes understudied. We evaluated the short-term mid-term DCD lungs managed or without EVLP.MethodsWe conducted retrospective review United Network Organ Sharing(UNOS) registry all primary adult transplants performed February 18, 2018 onwards, dichotomizing them as EVLP. Baseline characteristics were compared. Two-year survival was examined Kaplan Meier curves multivariable Cox proportional hazards regression.ResultsOf 757 transplants, 189(25%) EVLP no significant differences in characteristics. Recipients EVLP-managed had longer wait-list duration(40 vs 32 days, p=0.01), organ preservation times(12.6±3.8 6.6±2.2 hours, p<0.01), distance traveled[268 (98-490 132(49-305) nautical miles, p<0.01]. more likely to remain intubated (51% 43%, p=0.04), be on ECMO (22% 14%, have grade 3 graft dysfunction (31% 23%, p=0.04) at 72 hours. One(86% 77%) two-year(74% 65%, log-rank p=0.02) significantly worse lungs. On regression, associated two-year survival(adjusted HR 1.45, 95% CI 1.01-2.08) when time not used an adjuster(EVLP aHR 1.28, 0.74-2.21).ConclusionA quarter are States, inferior compared EVLP, possibly related obligate increase times. Further studies needed define role prior transplantation. Ex-vivo regression. Of 0.74-2.21). A