Ex vivo lung perfusion.

Abstract

Lung transplantation is a life-saving treatment for patients with end stage lung disease. The imbalance between lung graft supply and recipients has been a serious issue and barrier to successful lung transplantation. Ex vivo lung perfusion is a strategy wherein lungs are perfused and ventilated outside of the body. This technology has emerged as a safe preservation method that also enables the reassessment and reconditioning of marginal lung grafts. Ex vivo lung perfusion has successfully expanded the donor pool and led to greater lung transplant activity worldwide. Furthermore, ex vivo lung perfusion can be used as a platform for advanced diagnostics that enable specific targeted or personalized treatments that can be developed along a bench to bedside pathway leading to safe ex vivo intervention. Recent findings have shown that ex vivo lung perfusion could significantly and safely extend the preservation period, which enables transplant programs further optimization of the logistics around transplantation surgeries, and create a new paradigm whereby donor lungs are assessed at a centralized ex vivo lung perfusion center prior to delivery to a transplant clinic in need. The introduction of ex vivo lung perfusion to clinical lung transplantation has been a major step in the evolution and practice of lung transplantation.