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Acute kidney injury after ex vivo lung perfusion (EVLP).

Publication ,  Journal Article
Hauck, J; Osho, A; Castleberry, A; Hartwig, M; Reddy, L; Phillips-Bute, B; Swaminathan, M; Mathew, J; Stafford-Smith, M
Published in: Transplant Proc
December 2014

BACKGROUND: Ex vivo lung perfusion (EVLP) identifies viability for marginal organs but complicates and lengthens lung transplantation surgery. Preliminary evidence supports equivalency for EVLP-assisted versus traditional (non-EVLP) procedures regarding graft function, postoperative course, mortality, and survival. However, acute kidney injury (AKI), a common serious complication of lung transplantation, has not been assessed. We tested the hypothesis that EVLP-assisted and non-EVLP lung transplantations are associated with different AKI rates. METHODS: Demographic, procedural, and renal data were gathered for 13 EVLP-viable lung transplantations and a non-EVLP group matched 4:1 for single versus double, pulmonary disease, and age. AKI was defined by AKI Network (AKIN) criteria and peak creatinine rise relative to baseline (Δ%Cr) during the 1st 10 postoperative days. Chi-square was performed for AKIN and 2-tailed t test for %ΔCr. RESULTS: Patient and procedural characteristics were similar between the groups. One non-EVLP patient required postoperative dialysis. AKI rates were also similar, as assessed by both AKIN (EVLP 7/13 (54%) vs non-EVLP 32/52 (62%); P = .61) and %ΔCr (EVLP 91 ± 81% vs non-EVLP 72 ± 62%; P = .63). CONCLUSIONS: We did not observe different AKI rates between EVLP-assisted and traditional lung transplant procedures. Although 1 non-EVLP patient required dialysis, AKI rates were otherwise similar. These findings further support EVLP as a strategy to expand the organ pool and reduce concerns for high-renal risk recipients. The small sample size and retrospective design are limitations. However, our sample size is similar to other reports, and it is the first to analyze AKI after EVLP-assisted lung transplantation. Larger multicenter prospective studies are needed.

Duke Scholars

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Published In

Transplant Proc

DOI

EISSN

1873-2623

Publication Date

December 2014

Volume

46

Issue

10

Start / End Page

3598 / 3602

Location

United States

Related Subject Headings

  • Tissue and Organ Procurement
  • Survival Rate
  • Risk Assessment
  • Retrospective Studies
  • Perfusion
  • Organ Preservation
  • North Carolina
  • Middle Aged
  • Male
  • Lung Transplantation
 

Citation

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Hauck, J., Osho, A., Castleberry, A., Hartwig, M., Reddy, L., Phillips-Bute, B., … Stafford-Smith, M. (2014). Acute kidney injury after ex vivo lung perfusion (EVLP). Transplant Proc, 46(10), 3598–3602. https://doi.org/10.1016/j.transproceed.2014.06.068
Hauck, J., A. Osho, A. Castleberry, M. Hartwig, L. Reddy, B. Phillips-Bute, M. Swaminathan, J. Mathew, and M. Stafford-Smith. “Acute kidney injury after ex vivo lung perfusion (EVLP).Transplant Proc 46, no. 10 (December 2014): 3598–3602. https://doi.org/10.1016/j.transproceed.2014.06.068.
Hauck J, Osho A, Castleberry A, Hartwig M, Reddy L, Phillips-Bute B, et al. Acute kidney injury after ex vivo lung perfusion (EVLP). Transplant Proc. 2014 Dec;46(10):3598–602.
Hauck, J., et al. “Acute kidney injury after ex vivo lung perfusion (EVLP).Transplant Proc, vol. 46, no. 10, Dec. 2014, pp. 3598–602. Pubmed, doi:10.1016/j.transproceed.2014.06.068.
Hauck J, Osho A, Castleberry A, Hartwig M, Reddy L, Phillips-Bute B, Swaminathan M, Mathew J, Stafford-Smith M. Acute kidney injury after ex vivo lung perfusion (EVLP). Transplant Proc. 2014 Dec;46(10):3598–3602.
Journal cover image

Published In

Transplant Proc

DOI

EISSN

1873-2623

Publication Date

December 2014

Volume

46

Issue

10

Start / End Page

3598 / 3602

Location

United States

Related Subject Headings

  • Tissue and Organ Procurement
  • Survival Rate
  • Risk Assessment
  • Retrospective Studies
  • Perfusion
  • Organ Preservation
  • North Carolina
  • Middle Aged
  • Male
  • Lung Transplantation