Thoracic Organ Perfusion (TOP) Registry Annual Report - More Than 350 OCS Lung Transplants in the US
Recommended Citation
Huddleston S, Loor G, Garcha P, Smith M, Walia R, Hashimi S, Schaheen L, Song T, Siddique A, Langer N, Lee A, Kukreja J, Hartwig M, Nemeh H, Toyoda Y, Daneshmand M, Neujahr D, Durham L, Ardehali A, Bush E, Suarez E, Hertz M, Schwartz G, Grazia T, Katlaps G, Qureshi M, Belli E, Patel K. Thoracic Organ Perfusion (TOP) Registry Annual Report - More Than 350 OCS Lung Transplants in the US. J Heart Lung Transplant 2024; 43(4):S415-S416.
Document Type
Conference Proceeding
Publication Date
4-1-2024
Publication Title
J Heart Lung Transplant
Abstract
Purpose: TOP registry is an all-inclusive registry established to collect donor/recipient and post-transplant clinical outcomes on all OCS Lung transplants in the real world in the US. Methods: The TOP OCS cohort includes three donor sub-groups: 1) standard criteria donor lungs (SCDL) 2) donor lungs initially deemed unacceptable (DLIDU) and 3) others not meeting SCDL/DLIDU criteria. To benchmark clinical outcomes, data from the Organ Procurement and Transplantation Network (OPTN) database for consecutive lung transplants from same centers, transplanted using other preservation methods during the same time, constituted the Control cohort. TOP registry provided additional primary graft dysfunction (PGD) data for the OCS arm (not available for Control cohort). Cohorts were propensity matched to account for differences in recipient/donor characteristics. Results: A total of 372 OCS and 3959 Control patients were analyzed. 364/372 donor lungs placed on OCS were transplanted (utilization rate 97.8%). There were 77 SCDL, 202 DLIDU and 73 other lung transplants in the OCS cohort. Donors in the OCS cohort were older (39 vs 36 yrs; p<0.001), more likely to be donation after circulatory death (DCD) (25% vs 7%; p<0.001), expected cross clamp time>6 hrs (70% vs 37%; p<0.001) and more likely to have significant smoking history (9% vs 6%; p=0.022). Recipients in the OCS group were younger (58 vs 60 yrs; p=0.004) and more likely to be on ECMO at transplant (11% vs 7%; p=0.010) compared to Control cohort. When propensity matched on DCD, P/F ratio, donor age, recipient LAS and transplant year, OCS group had similar 1-year survival compared to the Control cohort (84.3 vs. 86.5%) (p=0.533). Despite the propensity match, OCS group had significantly longer cross clamp time (mean 664 vs 396 mins; p<0.001) compared to Control, so this was unable to be matched on due to lack of samples with similarly longer times in the Control cohort. Conclusion: OCS Lung enabled the use of extended criteria donor lungs from DBD and DCD donors and resulted in post-transplant outcomes that are similar to a matched cohort of standard criteria lung transplants. These results were achieved despite the OCS cohort having nearly double the cross-clamp time (>50% of OCS cohort had 10+ hours of cross-clamp time). These results support the broader use of OCS Lung technology to expand donor lung utilization for transplants from DBD and DCD donors.
Volume
43
Issue
4
First Page
S415-S416
