BACKGROUND Thoraco-abdominal normothermic regional perfusion (TA-NRP) has emerged as a strategy for evaluating and recovering the heart in controlled donation after the circulatory determination of death (cDCDD). However, its impact on lung grafts remains largely unknown. We aimed to assess the impact of TA-NRP on the outcomes of recipients of cDCDD lungs. METHODS This is a retrospective, multicenter, nationwide study describing the outcomes of cDCDD lung transplants (LTs) performed in Spain from January 2021 to November 2023. Patients were divided in 2 groups based on the recovery technique: TA-NRP with the simultaneous recovery of the heart vs abdominal NRP (A-NRP) without simultaneous heart recovery. The primary endpoint was the incidence of Primary Graft Dysfunction (PGD) grade 3 at 72 hours. Secondary endpoints included the overall incidence of PGD, days on mechanical ventilation, intensive care unit (ICU) and hospital length of stay, early survival rates, and mid-term outcomes. RESULTS Two hundred and eighty three cDCDD LTs were performed during the study period, 28 (10%) using TA-NRP and 255 (90%) using A-NRP. No differences were observed in the incidence of PGD grade 3 at 72 hours between the TA-NRP and the A-NRP group (0% vs 7.6%; p = 0.231), though the overall incidence of PGD was significantly lower with TA-NRP (14.3% vs 41.5%; p = 0.005). We found no significant differences between the groups regarding other post-transplant outcome variables. CONCLUSIONS TA-NRP allows the simultaneous recovery of both the heart and the lungs in the cDCDD scenario with appropriate LT outcomes comparable to those observed with the A-NRP approach.

中文翻译：

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胸腹与腹部常温区域灌注后对照 DCDD 肺移植的结果：西班牙经验。


背景 胸腹正常热区域灌注 （TA-NRP） 已成为循环死亡确定 （cDCDD） 后评估和恢复受控捐献心脏的一种策略。然而，它对肺移植物的影响在很大程度上仍然未知。我们旨在评估 TA-NRP 对 cDCDD 肺受者结局的影响。方法 这是一项回顾性、多中心、全国性研究，描述了 2021 年 1 月至 2023 年 11 月在西班牙进行的 cDCDD 肺移植 （LT） 的结果。根据恢复技术将患者分为 2 组： TA-NRP 同时心脏恢复与腹部 NRP （A-NRP） 无同步心脏恢复。主要终点是 72 小时时 3 级原发性移植物功能障碍 （PGD） 的发生率。次要终点包括 PGD 的总发生率、机械通气天数、重症监护病房 （ICU） 和住院时间、早期生存率和中期结局。结果 在研究期间进行了 283 例 cDCDD LTs，其中 28 例 （10%） 使用 TA-NRP，255 例 （90%） 使用 A-NRP。TA-NRP 组和 A-NRP 组在 72 小时内 PGD 3 级的发生率没有观察到差异 （0% vs 7.6%;p = 0.231），尽管 TA-NRP 组的 PGD 总发生率显着降低 （14.3% vs 41.5%;p = 0.005）。我们发现两组之间在其他移植后结局变量方面没有显著差异。结论TA-NRP 允许在 cDCDD 情景中同时恢复心脏和肺，其适当的 LT 结果与使用 A-NRP 方法观察到的结果相当。