Eurotransplant Annual Meeting 2015
Thoracic users meeting
Chair: G. Laufer
Speakers: S. Large, S. Messer, G. Warnecke, G. Lang, S. Eifert
Report by: J. Smits/I. Konter
Drs. Messer and Large from Papworth gave a presentation titled „Adult DCD heart transplantation, making every donor
count‟. They first showed that in the UK only 50% of wait listed patients were transplanted and 43% of them died or
deteriorated prior to transplantation. In the UK the DCD donationrates for kidneys is now 11.7 donors pmp, for livers 2.2
pmp, and lungs 0.5 pmp. It is estimated that on a yearly basis the UK could have 50 DCD heart donors, which would imply an
increase of 30% in heart transplantation.
Papworth is the world leader in adult DCD heart transplantation with 10 transplants until now and with a 6 month median
follow up, all patients are alive and at home.
Dr. Warnecke (GHO) explained that in Germany only 50% of all liver donors are also lung donors, so there should be a
potential to extend the donor pool.
At present there are 4 commercial systems for ex vivo lung perfusion, but only one of these devices is portable.
He described the results of the INSPIRE trial, where it was assessed whether standard criteria lung donors perfused by
portable EVLP machine perform better than cold storage. He showed that the patients in the EVLP arm had a 70% freedom
from PGD3 versus 82% in the cold storage group.
Then he described the results from the EXPAND trial which was a single arm trial assessing outcome of ECD lungs. The pilot
cases and the first EXPAND cases show promising results.
Dr. Lang (AWG) started with describing the results of patients bridged with ECMO to primary transplantation. Vienna now
has 100 cases, with excellent 5y survival rates over 60%. Then he mentioned that the introduction of ambulatory ECMO
devices, or awake ECMO, was a huge step forward for the patient‟s welfare allowing them for instance to have access to
physiotherapy. And finally he described how Vienna now uses ECMO during a standard lung transplantation instead of CPM.
Dr. Eifert (GML) started her talk by showing that the effect of gender in heart transplantation is controversial. However,
symptoms and severity of disease are gender dependent. There are differences in incidences and symptoms, and in drug
metabolism, in disease perception and coping with the disease. Due to estrogen protection long term survival after heart
transplantation is better for women than men, demonstrated by ISHLTt data.
Report Annual Meeting 2015 | Eurotransplant
17