The University of Alberta Negative Pressure Ventilation Ex-Vivo Lung Perfusion (NPV-EVLP) Trial

Inclusion Criteria

• •5.2 PRE-NPV-EVLP Donor Eligibility Criteria
• •1. Best ratio of the PaO2 to FiO2 of \< 300mmHg;
• •2. Pulmonary edema, defined as bilateral interstitial infiltrates without evidence of infection, detected on the last chest radiograph by the lung-transplantation physician assessing the donor;
• •3. Poor lung deflation or inflation during direct intraoperative visual examination at the donor site;
• •4. Donor age is ≥ 55 years;
• •5. Expected cold ischemic time \> 6 hours;
• •6. Blood transfusions ≥ 10 units; or
• •7. Donation after cardiac death (DCD), as defined by Maastricht category III (donor without a heartbeat and with cardiocirculatory death imminent after withdrawal of treatment) or category IV (cardiocirculatory death in a brain-dead donor).
• •1. Surgeon must be satisfied with the clinical evaluation and appearance of the lungs; if not, reason for refusal must be documented;
• •2. Lungs show PaO2/FiO2 ratio ≥ 350mmHg; AND
• •3. Deterioration of less than 15% from baseline for physiological measurements pulmonary vascular resistance (PVR), dynamic compliance and peak inspiratory pressure.
• •1. Patients on our institution's waitlist requiring bilateral transplantation
• •2. Male or Female 18 years of age or older
• •3. Written informed consent provided.