Ex vivo lung perfusion in lung transplantation

• Published in: General thoracic and cardiovascular surgery Vol. 69; no. 4; pp. 625 - 630
• Main Authors: Nakajima, Daisuke, Date, Hiroshi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.04.2021; Springer Nature B.V
• Subjects: Brain death; Cardiac Surgery; Cardiology; Clinical medicine; Clinical trials; Cold storage; Current Topics Review; Current Topics Review Article; Extracorporeal Circulation; Humans; Infections; Injuries; Ischemia; Japan; Lung - surgery; Lung Transplantation; Lung transplants; Medicine; Medicine & Public Health; Mortality; Organ Preservation; Perfusion; Pulmonary arteries; Surgical Oncology; Thoracic Surgery; Tissue Donors; Trauma; Ventilation; Ventilators; Japan; Sweden; Belgium; United States > US; Germany; Extended criteria donor; Organ preservation; Ex vivo lung perfusion; Lung transplantation
• ISSN: 1863-6705; 1863-6713; 1863-6713
• DOI: 10.1007/s11748-021-01609-1

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.