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Pulmonary Transplant Council Report


links image DAVID WEILL, MD
Chair, Pulmonary Transplant Council
dweill@stanford.edu


Since the ISHLT meeting in Prague last April, the Pulmonary Transplant Council has been hard at work. Our Council has taken on several new initiatives, including working on a revision of the lung transplant recipient selection guidelines. These guidelines were last published in 2006, and many of us on the Council thought it was an appropriate time to revisit the selection criteria given the changes in the allocation system and the willingness of many programs to consider patients that previously would have been deemed too high risk for transplant. Also, given that our field has continued to make important advances in the use of mechanical support systems, sicker patients are being safely bridged to transplant. We look forward to presenting new Selection Guidelines in 2013.

A number of suggestions for future Guidelines development were discussed during the Pulmonary Council meeting in Prague. This included standards and guidelines in lung donor management working closely with our colleagues in the organ procurement area and in post lung transplant management guidelines. The postoperative management guidelines would mirror a similar effort put forth by our cardiac colleagues a few years ago.

Our Council has also begun to make meaningful efforts toward establishing registries and databases that will provide programs access to clinical information regarding two important areas of innovation in our field: ex vivo lung perfusion (EVLP) and donation after cardiac death. Important data in each of these two areas need to be collected in order to inform clinical decisions in these rapidly evolving areas. The Council encourages full participation of all programs engaging in these activities so the data will be as robust as possible.

Also, our Council is considering conducting a thorough overview of ex vivo lung perfusion, focusing especially on how to establish an EVLP service, the use of acellular versus cellular perfusion, and indications for the use of EVLP. We expect that centers with significant experience in this area will lead the effort and help less experienced centers avoid "reinventing the wheel." This sort of clinical collaboration in newly evolving areas is key to the continued advancement of lung transplantation, and I believe the Pulmonary Transplant Council can take a lead role in this.

Thank you for your efforts in making the Pulmonary Transplant Council an active force for progress this year, and I look forward to seeing you all (for the Louisianans among us: ya'll) in Montréal in April.



Disclosure Statement: The author has no conflicts of interest to report.