XPS™ Jensen lung as a low-cost, high-fidelity training adjunct to ex-vivo lung perfusion

Abstract

Background: Ex vivo lung perfusion (EVLP) enables lung resuscitation before transplantation, and training is key, particularly in low-volume settings. To enable technique refinement and continuing education, we sought to demonstrate the value of a low-cost, high-fidelity EVLP simulator that would allow reproducible clinical scenarios.

Methods: In partnership with our EVLP manufacturer, we utilized the XPS™ Jensen Lung with our clinical system. The Jensen Lung has two simulated lung bladders and an in-line polymethylpentene fiber oxygenator. It allows titration of ventilator support which aids in accurate clinical simulation. For simulations, blood gases (BGs) were obtained and compared with integrated in-line perfusate gas monitors (PGMs). PaO₂ , PCO₂ , and pH were measured and compared.

Results: The PGM and BG values were not significantly different throughout the range of FiO₂ and sweep gas flow rates evaluated. The "delta" PaO₂ was measured between LA and PA and did not show any change between approaches. The pH measurement between BG and PGM was not significantly different.

Conclusions: The XPS™ Jensen Lung simulator allows for a high-fidelity simulator of clinical EVLP. The correlation of the PGM and the BG measurement of the PaO₂ and pH allow for a low-cost simulation, as the PGMs are in line in the circuit, and enable real-time tracking of perfusate gas parameters with the PGM. Implementation of a standardized clinical EVLP training program allows the maintenance of technique and enables clinical simulation training without the need for costly animal perfusions and the use of multiple BG measurements.

Keywords: XPS™ Jensen lung; ex-vivo lung perfusion; surgical simulation.