Original Title: Eficacia y seguridad de la perfusión ex vivo de pulmones como evaluación y acondicionamiento para el trasplante

Authors' objectives: To assess the effectiveness and safety of ex situ machine perfusion for lung transplantation

Authors' results and conclusions: Results Of a total of 1096 references, 6 observational studies were included. These works retrospectively analyzed the utilization of EVLP in transplant protocols. The retrospective observational design and the presence of confounding variables, such as the use of EVLP only in cases in which lung characteristics were worse, adds significant risks of bias in all included studies. No significant differences were found in primary graft dysfunction, or in survival, in the short, medium or long term, between the lungs treated with EVLP (those with worse conditions or from donors after circulatory death) and those from the hypothermic preservation group. Conclusions The evidence identified does not allow us to determine the effectiveness of EVLP for transplantation versus SCS. The use of EVLP allows the inclusion of lungs in worse conditions (donors after circulatory death and/or expanded criteria) compared to those used in PEH without worsening primary graft dysfunction or survival.

Authors' methods: Methods Systematic literature review, including health technology assessment reports, systematic reviews, metaanalysis and primary studies. The following reference databases were consulted until June 2024 (with free and controlled language): Medline (Ovid), Embase (Evidence Based Medicine), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library (Cochrane Review Database) y WOS (Web of Science). Also, we explored the following databases and webs: CADTH (Canadian Agency for Drugs and Technologies in Health), AHRQ (Agency for Healthcare Research and Quality), NICE (National Institute for Health and Care Excellence), HIS (Healthcare Improvement Scotland), HIQA (Health Information and Quality Authority) and the Spanish Network of Health Technology Assessment (RedETS). The selection of the studies and the analysis of their quality were carried out by two independent reviewers. The synthesis of the results was carried out qualitatively. The quality of the studies was assessed using the ROBINS-I.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/eficacia-y-seguridad-de-la-perfusion-ex-vivo-de-pulmones-como-evaluacion-y-acondicionamiento-para-el-trasplante/

Year Published: 2025

URL for published report: https://www.aetsa.org/download/publicaciones/Perfusion-ex-vivo-de-pulmones_web.pdf

Requestor: Spanish Health Ministry

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

DOI: 10.52766/AYKO7327

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: <p>Andalusian Agency for Health Technology Assessment (AETSA)</p>