In new guidance, the National Institute for Health and Care Excellence (NICE) approves ex-situ machine perfusion for extracorporeal preservation of lungs for transplant to allow better assessment of marginal lungs allowing them to be used more frequently, so increasing the number of lungs available for transplant.
NICE says the evidence on the safety and efficacy of the procedure is adequate to support its use, provided that standard arrangements are in place for clinical governance, consent and audit.
Clinicians and centres doing this procedure must follow the relevant regulatory and legal requirements of the Human Tissue Authority.
It is also recommended that clinicians should enter details about all patients having the procedure into the NHS blood and transplant organ donation and transplantation registry as well as details about the device used.
The recommendations are based on a rapid review of the published literature on the efficacy and safety of ex-situ machine perfusion. This comprised a detailed review of the evidence from seven sources, which comprised three meta-analyses, three retrospective cohort studies and one prospective case series.
Key efficacy outcomes were lung function after transplant, patient survival after transplant and quality of life. Key safety outcomes were primary graft dysfunction and prolonged lung recovery (e.g., needing extracorporeal membrane oxygenation).
This article originally appeared on Univadis, part of the Medscape Professional Network.
