C47-15 Outcomes in Lung Transplantation Using Controlled Hypothermic Preservation With and Without Extended Ischemic Times

Rationale The historical standard for transporting donor lungs involves storing donor organs on ice. Animal models showed potential benefit to maintaining temperatures above the -4-0 °C seen with ice storage. The LUNGguard donor preservation system (LG) keeps donor lungs between 4-8 °C. Early reports with controlled hypothermic preservation (CHP) have suggested clinical outcomes equivalent to traditional ice storage. In this study, we evaluated post-transplant outcomes using CHP with ischemic times kept within the traditional ice storage range and compared them to CHP with extended ischemic times and ice storage Methods We evaluated patients who underwent single and bilateral lung transplant at Houston Methodist Hospital between January 2019 and December 2024 using CHP via LG or ice storage. Recipients of multi-organ transplants and redo-lung transplants were excluded. We compared LG patients with ischemic time less than or equal to 8 hours (LG < 8h) with LG patients with ischemic time greater than 8 hours (LG > 8h) and ice storage (ICE). Our primary outcome was 1-year survival. Secondary outcomes included grade 3 PGD at 72 hours, post-transplant ICU length of stay (LOS), and post-transplant hospital length of stay. Results We had a total of 59 cases in the LG < 8h group, 41 cases in the LG > 8h group, and 90 cases in the ICE group. The average recipient age in years was 60.5 for the LG > 8h, 60.6 for LG < 8h, and 59.5 for ICE. There was no difference in 1-year survival between the LG < 8h and the LG > 8h groups (p = 0.696); nor was there any difference between the LG < 8h and the ICE groups (p = 0.265). Additionally, the incidence of grade 3 PGD at 72 hours was similar between LG < 8h and LG > 8h (p = 1.00), and between LG < 8h and ICE (p = 0.342). We also did not see any significant difference in post-transplant ICU LOS and hospital LOS between LG < 8h and the other two groups. Conclusion CHP is increasingly being utilized as a means of transporting donor lungs, often with extended ischemic times. We saw no difference in outcomes between LG cases with and LG without extended ischemic times. We also noted no difference in outcomes between LG and traditional ice when ischemic time was kept within 8 hours. This abstract is funded by: None