BACKGROUND Real-time lung weight (LW) measurement is a simple and noninvasive technique for detecting extravascular lung water during ex vivo lung perfusion (EVLP). We investigated the feasibility of real-time LW measurement in clinical EVLP as a predictor of transplant suitability and post-transplant outcomes. METHODS In our clinical acellular EVLP protocol, real-time LW was measured in 117 EVLP cases from June 2019 to June 2022. The estimated LW gain at each time point was calculated using a scale placed under the organ chamber. The lungs were classified into 4 categories based on LW adjusted for height and compared between suitable and unsuitable cases. The relationship between estimated LW gain and primary graft dysfunction was also investigated. RESULTS The estimated LW gain during the EVLP significantly correlated with the LW gain (post-EVLP LW and pre-EVLP LW) measured on the back table (R2 = 0.61, p < 0.01). In the adjusted LW categories 2 to 4, the estimated LW gain at 0-1 hour after EVLP was significantly higher in unsuitable cases than in suitable cases. The area under the curve for the estimated LW gain was ≥0.80. Primary graft dysfunction grades 0 to 1 had a significantly lower estimated LW gain at 60 minutes than grades 2 to 3 (-43 vs 1 g, p < 0.01). CONCLUSIONS Real-time lung measurements can predict transplant suitability and post-transplant outcomes by the early detection of extravascular lung water during the initial 1 hour of EVLP.

中文翻译：

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临床离体肺灌注期间的实时肺重量测量。


背景 实时肺重量 （LW） 测量是一种简单的无创技术，用于检测离体肺灌注 （EVLP） 期间的血管外肺水。我们研究了临床 EVLP 中实时 LW 测量作为移植适用性和移植后结局预测因子的可行性。方法 在我们的临床脱细胞 EVLP 方案中，从 2019 年 6 月到 2022 年 6 月，在 117 例 EVLP 病例中测量了实时 LW。使用放置在器官腔下方的刻度计算每个时间点的估计 LW 增益。根据身高调整的 LW 将肺分为 4 类，并比较合适和不适合的病例。还研究了估计的 LW 增加与原发性移植物功能障碍之间的关系。结果 EVLP 期间估计的 LW 增益与在后表上测量的 LW 增益 （EVLP 后 LW 和 EVLP 前 LW） 显著相关 （R2 = 0.61，p < 0.01）。在调整后的 LW 类别 2 至 4 中，不合适病例在 EVLP 后 0-1 小时的估计 LW 增加显著高于合适病例。估计 LW 增益的曲线下面积为 ≥0.80。0 至 1 级原发性移植物功能障碍在 60 分钟时的估计 LW 增加显著低于 2 至 3 级 （-43 vs 1 g，p < 0.01）。结论 实时肺部测量可通过在 EVLP 最初 1 小时内早期检测血管外肺水来预测移植适宜性和移植后结局。