Mesenchymal Stromal Cell Therapy in Lung Transplantation

Lung transplantation is often the only viable treatment option for a patient with end-stage lung disease. Lung transplant results have improved substantially over time, but ischemia-reperfusion injury, primary graft dysfunction, acute rejection, and chronic lung allograft dysfunction (CLAD) continue to be significant problems. Mesenchymal stromal cells (MSC) are pluripotent cells that have anti-inflammatory and protective paracrine effects and may be beneficial in solid organ transplantation. Here, we review the experimental studies where MSCs have been used to protect the donor lung against ischemia-reperfusion injury and alloimmune responses, as well as the experimental and clinical studies using MSCs to prevent or treat CLAD. In addition, we outline ex vivo lung perfusion (EVLP) as an optimal platform for donor lung MSC delivery, as well as how the therapeutic potential of MSCs could be further leveraged with genetic engineering.

Automated summary

Lung transplantation is often the only option for end-stage lung disease patients. Mesenchymal stromal cells (MSC) have anti-inflammatory and protective effects, which have potential benefits in solid organ transplantation. This review discusses the experimental studies on using MSC to protect donor lungs from ischemia-reperfusion injury and alloimmune responses, as well as the studies on using MSC to prevent or treat chronic lung allograft dysfunction. The ex vivo lung perfusion (EVLP) is also mentioned as an optimal platform for MSC delivery, and the potential of genetic engineering to enhance the therapeutic potential of MSCs.