Rising to the Challenge of Unmet Need: Expanding the Lung Donor Pool

摘要

There is a shortage of lungs available to meet the needs of patient who require lung transplantation. Ex vivo lung perfusion (EVLP) has allowed for the assessment and reconditioning of extended criteria and high-risk donor lungs, allowing for an increased volume of lung transplants. Recently, an invested interest in the utilization donation after cardiac death (DCD) donors has surfaced, in which EVLP has played an important role. Clinical studies have shown that EVLP can recondition donor lungs that initially would be unacceptable for transplantation. In a recent study, the intervention of EVLP was also shown to extend the window of total organ preservation time. Preclinical studies have shown promising results for EVLP to serve as a therapeutic platform to modulate inflammation, reduce edema, and treat infections and aspiration injuries. In addition, studies have shown the potential to recondition lungs of donation after cardiac death donors which suffer from additional injury in comparison to donation after brain death donors. EVLP is dynamic platform that can serve to treat and array of issues prior to transplantation. Indeed, the investigation of these therapeutic arsenals will soon allow physicians to expand the donor organ pool and improve transplantation outcomes.