How to Recondition Ex Vivo Initially Rejected Donor Lungs for Clinical Transplantation: Clinical Experience from Lund University Hospital

Figure 4

Flowchart illustrating the evaluation of ex vivo reconditioned lungs for clinical transplantation. During the evaluation, the lung is fully ventilated and the perfusate blood is deoxygenated. The gases entering the oxygenator are mixed to obtain values of pCO₂ of 4.5–5 kPa. At this point, the perfusion flow was 4–6 L/min (i.e., full flow). Samples of the perfusate blood are taken before and after passing through the lung (i.e., venous and arterial blood samples) after 5 minutes’ exposure to FiO₂ of 0.21, 0.5, and 1.0 in order to measure blood gases. A deflation test is then performed. If the deflation test is normal and the PaO₂ with FiO₂ = 1.0 was 50 kPa or higher, the lungs are accepted for transplantation.