| Today available in France for research purposes only. |
STEEN Solution™ ex-vivo assessment could expand the donor lung pool.
STEEN Solution™ is intended for assessment of isolated lungs after removal from the donor for eventual transplantation into a recipient.
About four of every five lungs offered for transplantation are currently rejected by present selection criteria. 1, 2
However, lungs from marginal and extended donors have been sucessfully used for transplantation for at least a decade and the concept is gradually gaining acceptance.3, 4, 5
The ex-vivo assessment of marginal lung function, including gaseous exchange, at 37 ºC was orginally developed for non heart beating donor lungs by Steen et al6, 7 and has since been adopted by other centers.8, 9.
Closed circuit perfusion of the lung mimics in-vivo conditions; the ventilated lung is perfused with a 15% deoxigenated suspension of red cells in STEEN Solution™ and the circuitry monitors critical parameters of gaseous exchange, pulmonary vascular resistance and other key variables under normothermic conditions. The STEEN Solution™ perfusate and circuitry can maintain stable lung function, without oedema formation, for at least two hours at 37 ºC.7, 8 |
The STEEN Soultion™ perfusate and machine perfusion methodology permit:
- A more refined functional ex-vivo evaluation of accept/reject criteria
- Normothermic functional evaluation without oedema formation
- Permits more rational allocation and use of donor lungs
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Bibliography
1. Ware LB et at. Lancet 2002, 360:619-20.
2. Pierre A F et al. J thorac CardioVasc Surg. 2002,123;3:421-8.
3. Kron I et al. Ann Surg. 1993;217:518-24
4. Sundaresan S et al. J. thorac Cardiovasc Surg. 1995, 109:1075-80
5. Shumway S et al. Ann Thorac Surg. 1994, 57:92-5
6. Steen S et al. Lancet 2001,357:825-829
7. Steen S et al. Ann Thorac Surg 2003,76:244-52
8. Neyrinck A et al. J Heart Lung Transplant 2004,23;173 (abstr)
9. Wierup P et al. Ann Thorac Surg 2006,81:460-6
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