Ex vivo lung perfusion (EVLP)

Abstract

The number of patients listed for lung transplantation largely exceeds the number of available transplantable organs because of both a shortage of organ donors and a low utilization rate of lungs from those donors. A novel strategy of donor lung management—ex vivo lung perfusion (EVLP)—that keeps the organ at physiological protective conditions has shown a great promise to increase lung utilization by re-evaluating, treating, and repairing donor lungs prior to transplantation. A clinical trial using EVLP has shown the method to be safe and to allow for reassessment and improvement in function from high-risk donor lungs from both brain death and cardiac death donors prior transplantation. When these lungs were transplanted, low rates of primary graft dysfunction were achieved, and the early outcomes were similar to those with conventionally selected and transplanted lungs. Pre-clinical studies have also shown a great potential of EVLP as a platform for the delivery of novel therapies to repair injured organs ex vivo, and thus further increase the donor lung utilization rate.