Abstract
Lung transplantation is a life-saving intervention for patients with end-stage lung diseases. However, ultimately, the success of lung transplantation is dependent on the quality and function of the transplanted donor lungs, which are frequently subjected to multiple different injuries. Recent innovations, in particular the development of ex vivo lung perfusion (EVLP) in which donor lungs are preserved under normothermic conditions outside the body, have enabled clinicians to more accurately evaluate the donor lung function prior to transplantation and have significantly impacted donor lung assessment and utilization worldwide. The advancement of EVLP from organ assessment to organ repair will be the next important and challenging step not only to expand the donor lung pool but also to improve graft survival and long-term outcomes after transplantation. The application of enhanced EVLP techniques combined with targeted repairs and molecular therapeutic strategies, including gene and cell-based therapy, will result in improved rehabilitation of injured donor lungs and provide a framework for the application of a personalized medicine approach in lung transplantation.
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