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Objective: We hypothesized that regadenoson, an adenosine A2A receptor agonist, will increase the use rate after ex vivo lung perfusion and reduce ischemic reperfusion injury. Methods: This randomized (2:1), multicenter, blinded, placebo-controlled trial (NCT04521569) treated donor lungs with a regadenoson infusion (1.44 μg/kg/h, n = 26) or placebo (n = 8) during ex vivo lung perfusion. Eligibility criteria were adapted from the NOVEL trial. The rate of use of donor lungs was the primary end point. Secondary end points were primary graft dysfunction scores and 30-day safety. Results: .87). No adverse events were related to the study treatment. Conclusions: There was no significant increase in the use of marginal donor lungs or a decrease in ischemic reperfusion injury in lungs undergoing ex vivo lung perfusion with regadenoson compared with placebo. Regadenoson is a safe ex vivo lung perfusion adjunct. The use rate of the placebo group was greater than the expectation set in the NOVEL trial of 51%, making it difficult for the regadenoson group to have a significant increase in use.
Fleischmann et al. (Tue,) studied this question.