F-127CAN EX VIVO LUNG PERFUSION IMPROVE THE OUTCOME OF SINGLE LUNG TRANSPLANTATION WHEN THE CONTRALATERAL LUNG IS INJURED?
Bibliographic record
Abstract
Objectives: Single lung transplantation (SLTx) is an acceptable option for selected patients with pulmonary fibrosis and emphysema. We have previously demonstrated that SLTx carries an increased risk of early death if the contralateral donor lung is severely injured. We sought to determine the impact of ex vivo lung perfusion (EVLP) in improved selection of single donor lungs for transplantation. Methods: All SLTx performed from January 2009 to August 2014 in our institution were reviewed. Recipients were classified into 3 groups according to the fate of the contralateral lung: G1) contralateral lung allocated; G2) contralateral lung declined without EVLP; G3) contralateral lung declined after EVLP. Endpoints included 90-day mortality, primary graft dysfunction (PGD), ICU length of stay (LOS), Hospital LOS, and 1-year mortality. Results: During the study period, 93 recipients (mean age 61.5 ± 8.8 years) underwent SLTx for idiopathic pulmonary fibrosis (IPF, n = 65), COPD/emphysema (n = 24), and miscellaneous interstitial diseases (n = 4). Among them, 41 patients were classified as G1, 34 patients were classified as G2, and 18 patients were classified as G3. The proportion of patients with IPF was not significantly different between groups (P = 0.3420). The proportion of patients who experienced a PGD grade III at any time during the first 72 hours was significantly lower in G1 (n = 11, 26%) and G3 (n =5, 27%) than in G2 (n = 19, 55%, P = 0.0223). There was no significant difference between groups regarding 90-day mortality, ICU length of stay (LOS), hospital LOS, and 1-year mortality. Conclusions: This study confirms that SLTx carries an increased risk of adverse outcome if the contralateral donor lung is injured and no EVLP is performed to test the organ prior to transplantation. Further studies are needed to determine the role of EVLP in this setting. Disclosure: T.K. Waddell, S. Keshavjee, M. Cypel: Co-founders of Perfusix Canada/USA and XOR Labs Toronto Inc.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".