FILONEX - A prospective, randomized controlled pilot safety study evaluating the addition of hemodiafiltration to EVLP in marginal donor lungs.
Panja M Boehm, Sophia Auner, Oya Berezhinskiy et al.
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In 30 seconds
The FILONEX trial evaluated the safety and feasibility of adding hemodiafiltration (HDF) to ex vivo lung perfusion (EVLP) in 30 marginal donor lungs. This single-center randomized controlled trial found that the acceptance rate for transplantation was significantly higher in the HDF group at 80% compared to 47% in the control group. No cases of primary graft dysfunction grade 3 were observed at 72 hours in either group.
Key findings
- Acceptance rate for transplantation was 80% in the treatment group versus 47% in the control group.
- Primary graft dysfunction grade 3 at ICU admission was 25% in the treatment group compared to 57% in the control group.
- Electrolyte levels, lactate, and pH remained within physiological ranges only in the treatment group.
Why it matters
This study suggests that integrating hemodiafiltration into EVLP may enhance the viability of marginal donor lungs, potentially improving transplantation outcomes. Clinicians should consider the implications of maintaining physiological perfusate conditions during lung preservation.