ArticleJHLT open2026
Ex vivo lung perfusion in donation after circulatory death lung transplantation: A systematic review and meta-analysis.
Article in JHLT open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
Background: Lung transplantation is the definitive therapy for end-stage lung disease, but donor shortages contribute to high waiting list mortality. Donation after circulatory death (DCD) expands the donor pool, and ex vivo lung perfusion (EVLP) enables graft assessment and optimization. However, its impact in this setting remains uncertain. This meta-analysis aimed to evaluate whether EVLP in DCD lungs affects graft function and short-term outcomes compared with direct transplantation. Methods: Three databases were searched. The main outcome was grade 3 primary graft dysfunction (PGD). Additional outcomes included intensive care unit (ICU) and hospital length of stay (LOS), both analyzed quantitatively. Outcomes assessed qualitatively comprised short-term survival, pneumonia, and acute rejection. Random-effects models were applied to quantitative analyses. Results: Five observational studies (654 patients) were included. The incidence of grade 3 PGD was comparable between EVLP and non-EVLP groups (RR 1.29; 95%CI 0.97 to 1.71; Conclusion: EVLP in DCD lung transplantation was not associated with significant differences in grade 3 PGD, ICU or hospital LOS, or short- to mid-term outcomes compared with direct transplantation. Given its time and resource demands, EVLP may not be necessary for all DCD grafts; however, it remains particularly valuable for evaluating uncertain-quality lungs, where its selective use can help ensure graft safety.
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