Long-term survival and development of chronic graft dysfunction after donor lung perfusion repair in isolated lungs-a meta-analysis

Abstract Background EVLP is deemed successful in enhancing the pool of candidates for lung transplantation subject to a reevaluation of the donor lung’s physiological and biological performance, in addition to an increased preservation period, and aids in healing damaged lung. This meta-analysis aimed to evaluate the impact of EVLP on long-term patient outcomes compared to conventional lung transplantation. Methods The data about conventional lung transplantation without ELVP and lung transplantation with EVLP repair were collected. The data were subjected to analysis like receptor baseline values and surgical outcomes, while OR, MD, and HR were employed as effect sizes. Results Among the collected literature, ten publications were deemed qualified for incorporation into the study, comprising one prospective cohort and nine retrospective cohort studies, with 5471 donors and 5464 receivers. Those subjects with marginal donor lungs examined and treated with EVLP exhibited equivalent overall and CLAD-free survival compared to those with conventional donor lungs. Moreover, donors in the EVLP group had higher chest X-ray abnormalities and lower P/F. The two groups had no significant difference in developing grade 3 PGD3 post 72 hours of surgery, but the EVLP group required a more extended ICU stay. Other postoperative results for the two groups were comparable. Conclusions The donor lung’s quality was lower in the ELVP group; however, those with donor lung EVLP screening and therapy had comparable overall and CLAD-free survival to those who underwent conventional donor lung.