Ex vivo lung perfusion in lung transplantation

Lung transplantation is an established life-saving intervention for patients with end-stage lung diseases. The success of lung transplantation mainly depends on the quality and function of the implanted donor lungs, which are frequently subject to brain-death-induced lung injuries and intensive care unit (ICU)-related complications before transplantation. Recent innovations, particularly the development of ex vivo lung perfusion (EVLP), in which donor lungs are ventilated and perfused under normothermic conditions outside the body, have allowed clinicians to more accurately assess the donor lung function prior to transplantation. Therefore, EVLP has been successfully translated into clinical practice with the expansion of the donor lung pool, leading to favorable post-transplant outcomes in a growing number of transplant centers worldwide. The EVLP system and techniques, following the Toronto protocol, have recently been applied for the assessment of extended criteria brain-death donors in clinical lung transplantation in Japan. The advancement of EVLP from organ assessment to organ treatment will be the next challenging stage not only to expand donor lung pool, but also to improve graft survival and long-term outcomes after transplantation.

Automated summary

Lung transplantation is an established life-saving intervention for patients with end-stage lung diseases, and the success largely depends on the quality and function of the implanted donor lungs. The development of ex vivo lung perfusion (EVLP) has allowed for more accurate assessment of donor lung function, leading to expansion of the donor lung pool and improved post-transplant outcomes. The advancement of EVLP from organ assessment to organ treatment is the next challenging stage to further enhance graft survival and long-term outcomes after lung transplantation.