Abstract
National OCS Lung Procurement (NOP) of donor lungs utilizes a national network of dedicated cardiothoracic surgical procurement and OCS perfusion experts to procure, perfuse and assess donor lungs from donors to recipients. Using the TOP Registry data, this report compared post-transplant outcomes for lung transplanted using NOP vs traditional center-driven procurement and management of OCS Lung perfusion (Direct).
The TOP registry is a multi-center, all-inclusive observational registry that was established to collect perfusion parameters and post-transplant clinical outcomes for lung transplants performed with donor lungs perfused and assessed on the OCS Lung system.
We evaluated the impact of OCS Lung NOP on post-transplant survival in the TOP Registry patient cohort to discern any clinical correlation. We stratified the TOP Registry data between December 2019 and June 2022 into two groups; NOP group and Direct group.
Data from 262 OCS Lung transplant recipients in the registry were available for analysis. Of these, 108 patients were in NOP group and 154 patients were in the Direct group. Significant differences were seen in total cross-clamp times NOP 638 (range 285-1,886 mins) vs. Direct 548 mins (range 274-971 mins) (p=0.004); and total OCS perfusion time NOP 471 mins (range 162-1624 mins) vs. Direct 384 mins (range 27-858 mins) (p=0.004). The 1-year survival, probability was 84.8% in the NOP group, and 81.4% in the Direct group (Log-rank p= 0.436 - Figure 1)
NOP enabled distant procurement of donor lungs while resulting in similar survival outcomes compared to traditional direct method. This finding demonstrates that NOP is a valid method to enable lung transplant programs to expand their capability to utilize donor lungs from outside the historical standard acceptance radius. Importantly, the NOP could enable better manage transplant procedure logistics and clinical staffing.