Organ perfusion, with us since the days of Carrel and Lindbergh, is coming into vogue across all of transplantation. As we expand the use of organs from donation after cardio-circulatory death donors, and increasingly appreciate the scope for damage after brain stem death, per-fusion of isolated organs is being seen as a solution to some of the problems of both organ number and quality.The lung has lead the way, perhaps not only because it is vulnerability to the sequelae of brain death (I) but also because of its unique suitability to donation after circulatory death. Cellular metabolism of the lung can be maintained by simple inflation, in the absence of a circulation, probably for several hours (2). So ischemia is less an issue than assessment of function. In a life-supporting organ, reliable assessment is crucial.
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