Abstract
Lung transplantation is a lifesaving therapy for patients suffering from end-stage lung diseases. The number of patients waiting for lung transplantation greatly exceeds the number of donors available. Currently, only 20% of lungs donors are used for transplantation. Ex vivo lung perfusion (EVLP) has been developed as a tool to assess and also potentially repair lungs before transplantation. This article will review the rationale for EVLP and the different EVLP methods including the Toronto EVLP method, describe technical details of EVLP, report on the clinical results of EVLP, and describe the use of EVLP as a platform to deliver different therapies. EVLP has been demonstrated to be a safe method of assessing high-risk donor lungs. The long-term survival and graft function of patients that received high-risk donor lungs assessed and treated with EVLP have been shown to be comparable to those receiving conventional donor lungs. Preclinical studies demonstrate that EVLP can serve as a platform for the delivery of specifically targeted therapies to repair injured lungs. EVLP has demonstrated to be a promising tool for the assessment and recovery of injured donor lungs using pharmacologic agents as well as gene and cellular therapies.
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