{
    "abstract": "To overcome limitations of traditional ex vivo lung perfusion (EVLP) for controlled donation after circulatory death (cDCD) lungs, this study aimed to evaluate a novel pulmonary abdominal normothermic regional perfusion (PANRP) technique, which we uniquely designed, for in situ assessment of lungs from cDCD donors.\nWe modified the abdominal normothermic regional perfusion circuit for simultaneous lung and abdominal organ assessment using independent extracorporeal membrane oxygenation components. Blood was oxygenated via a membrane oxygenator and returned to the body, with pulmonary flow adjusted to maintain pressure\u2009<\u200925\u00a0mmHg. Femoral cannulation was performed, and the lungs were ventilated with standard settings. Organ function was assessed over 2\u00a0h using PaO2/FiO2, AST, ALT, BUN, and Cr measurements to monitor perfusion and oxygen delivery.\nPANRP maintained stable lung function, with P/F ratios above 300, and preserved abdominal organ parameters, including stable AST, ALT, BUN, and Cr levels. Adequate urine output was observed, indicating normal renal function. Pulmonary artery pressure remained\u2009<\u200920\u00a0mmHg, and pulmonary vascular resistance was kept at 400 dyn\u30fbs/cm\nPANRP offers a promising alternative to traditional EVLP for cDCD lung evaluation, allowing in situ assessment of multiple organs simultaneously. This approach may overcome logistical and economic challenges associated with ex vivo techniques, enabling a more efficient evaluation process. Further studies are warranted to confirm its clinical applicability and impact on long-term outcomes.",
    "authors": [
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan. shin-tnk-5@s.okayama-u.ac.jp.",
            "firstname": "Shin",
            "initials": "S",
            "lastname": "Tanaka"
        },
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.",
            "firstname": "Masashi",
            "initials": "M",
            "lastname": "Umeda"
        },
        {
            "affiliation": "Department of General Thoracic Surgery, Shimane University Graduate School of Medicine, Shimane, Japan.",
            "firstname": "Hiroyuki",
            "initials": "H",
            "lastname": "Ujike"
        },
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.",
            "firstname": "Tsuyoshi",
            "initials": "T",
            "lastname": "Ryuko"
        },
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.",
            "firstname": "Yasuaki",
            "initials": "Y",
            "lastname": "Tomioka"
        },
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.",
            "firstname": "Kentaroh",
            "initials": "K",
            "lastname": "Miyoshi"
        },
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.",
            "firstname": "Mikio",
            "initials": "M",
            "lastname": "Okazaki"
        },
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.",
            "firstname": "Seiichiro",
            "initials": "S",
            "lastname": "Sugimoto"
        },
        {
            "affiliation": "Department of General Thoracic and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, Japan.",
            "firstname": "Shinichi",
            "initials": "S",
            "lastname": "Toyooka"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1007/s11748-025-02137-y\n10.1111/ajt.15677\n10.1016/j.athoracsur.2015.05.008\n10.1016/j.healun.2015.08.015\n10.1016/j.jss.2017.09.029\n10.1111/j.1600-6143.2008.02231.x\n10.1016/j.healun.2018.08.006\n10.1016/j.ccm.2022.10.006\n10.1111/ajt.15520\n10.1111/j.1432-2277.2011.01257.x\n10.1097/MOT.0000000000000500\n10.3389/fmed.2021.808719\n10.1111/ajt.12927\n10.1111/ajt.17057\n10.1111/ajt.13124\n10.1186/s12913-019-4154-6\n10.1111/ajt.14214\n10.1056/NEJMoa1014597\n10.1111/ajt.15241\n10.1093/ejcts/ezaa398\n10.1097/TXD.0000000000001450\n10.3310/hta20850\n10.1016/j.jtcvs.2019.07.087\n10.1016/j.trre.2019.06.001\n10.1016/j.jtcvs.2021.07.059",
    "journal": "General thoracic and cardiovascular surgery",
    "keywords": [
        "Abdominal normothermic regional perfusion",
        "Donation after circulatory death",
        "Lung preservation"
    ],
    "methods": null,
    "publication_date": "2025-03-16",
    "pubmed_id": "40089938\n26210946\n26454741\n29433886\n30297241\n36774170\n29324518\n35004787\n37040930\n31117992\n21488765\n36845854\n27897967\n31548078\n31239189\n34728084",
    "results": "PANRP maintained stable lung function, with P/F ratios above 300, and preserved abdominal organ parameters, including stable AST, ALT, BUN, and Cr levels. Adequate urine output was observed, indicating normal renal function. Pulmonary artery pressure remained\u2009<\u200920\u00a0mmHg, and pulmonary vascular resistance was kept at 400 dyn\u30fbs/cm",
    "title": "Novel pulmonary abdominal normothermic regional perfusion circuit for simultaneous in-donor evaluation and preservation of lungs and abdominal organs in donation after circulatory death.",
    "xml": "<Element 'PubmedArticle' at 0x788504036f70>"
}