Lung Procurement in Patient with Pulmonary Thromboembolism and Retrograde Perfadex Washout

Lung procurement for transplantation follows a meticulous, time-sensitive process to ensure organ viability. First, the donor is identified and assessed for suitability, considering factors like oxygenation, absence of infection, and lack of significant lung disease. Once brain death is confirmed and consent is obtained, the surgical team prepares for retrieval. In the operating room, the donor is heparinized to prevent clot formation, and a cold preservation solution (such as Perfadex) is infused into the pulmonary arteries to minimize ischemic injury. The lungs are carefully ventilated and inflated to optimal volume before being excised en bloc or as single lungs. After retrieval, the lungs are placed in a sterile, ice-cold preservation solution and packed in multiple layers to maintain low temperatures. For interstate transportation, the organ is quickly transferred to a transport container with temperature monitoring and flown or driven to the recipient’s transplant center. Coordination between donor and recipient teams is crucial to minimize cold ischemic time, ideally keeping it under six hours, to ensure successful transplantation.