{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:04:29Z","timestamp":1789545869291,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T00:00:00Z","timestamp":1686873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ex vivo lung perfusion (EVLP) is a method for the evaluation and reconditioning of high\u2010risk donor lungs to increase the pool of potential donor lungs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed all consecutive patients who received lung transplants from May 2012 to May 2017 with follow\u2010up until July 2021. EVLP was used in lungs initially rejected due to inadequate oxygenation but without other contraindications. Lungs with improved oxygenation levels above the threshold were transplanted. The primary endpoint was the time to graft failure, which was defined as the time from surgery to death or re\u2010transplantation, whichever occurred first. The secondary outcome was freedom from chronic lung allograft dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 157 patients underwent transplantation during the study period. Thirty\u2010nine patients received EVLP\u2010treated donor lungs. Restricted mean graft survival time up to 7\u2009years is 5.14\u2009years for non\u2010EVLP and 4.19 for EVLP, the difference being \u22120.95 (confidence interval [CI]\u20141.93 to 0.04, <jats:italic>p<\/jats:italic>\u2009=\u2009.059). The hazard ratio is 1.66 (CI 1.00\u20132.75, <jats:italic>p<\/jats:italic>\u2009=\u2009.046). Chronic lung allograft dysfunction was the highest contributor to mortality in both groups. There were significant differences in freedom from chronic lung allograft dysfunction at 12 and 24\u2009months of follow\u2010up (<jats:italic>p<\/jats:italic>\u2009=\u2009.005 and <jats:italic>p<\/jats:italic>\u2009=\u2009.030, respectively). Subgroup analyses revealed that the first patients who received EVLP in 2012\u20132013 had a substantially worse 5\u2010year graft survival than those who received EVLP more recently in 2016\u20132017 (14.3% vs. 60.0%). For the latter, the 5\u2010year graft survival was observed to be remarkably close to the non\u2010EVLP group (60.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long\u2010term survival was significantly lower, and lung function was poorer among recipients in the EVLP group than in the non\u2010EVLP group. However, the outcome of patients who received EVLP\u2010treated lungs was observed to improve steadily after the first 2\u2009years after EVLP was introduced in Denmark.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14296","type":"journal-article","created":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T05:29:26Z","timestamp":1686979766000},"page":"1210-1218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Transplantation of initially rejected donor lungs using ex vivo lung perfusion: A 5\u2010year experience"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5861-2590","authenticated-orcid":false,"given":"Karin","family":"Graeser","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen 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