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Review
. 2015 Feb 3:21:9-14.
doi: 10.12659/MSMBR.893674.

Ex vivo lung perfusion - state of the art in lung donor pool expansion

Aron-Frederik Popov  1 , Anton Sabashnikov  1 , Nikhil P Patil  1 , Mohamed Zeriouh  1 , Prashant N Mohite  1 , Bartlomiej Zych  1 , Diana Garcia Saez  1 , Bastian Schmack  2 , Arjang Ruhparwar  2 , Pascal M Dohmen  3 , Matthias Karck  2 , Andre R Simon  1 , Alexander Weymann  1
Affiliations
Review

Ex vivo lung perfusion - state of the art in lung donor pool expansion

Aron-Frederik Popov et al. Med Sci Monit Basic Res. .

Abstract

Lung transplantation remains the gold standard for patients with end-stage lung disease. Nevertheless, the number of suitable donor lungs for the increasing number of patients on the waiting list necessitates alternative tools to expand the lung donor pool. Modern preservation and lung assessment techniques could contribute to improved function in previously rejected lungs. Ex vivo lung perfusion (EVLP) already demonstrated its value in identification of transplantable grafts from the higher risk donor pool. Moreover, lungs from EVLP did not show significantly different postoperative results compared to standard criteria lungs. This could be explained by the reduction of the ischemia-reperfusion injury through EVLP application. The aim of this article is to review technical characteristics and the growing clinical EVLP experience with special attention to EVLP application for donation after cardiac death (DCD) lungs.

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Figures

Figure 1
Figure 1
Completed left atrial cuff-cannula anastomosis during preparation for EVLP.
Figure 2
Figure 2
Representative image showing the cannulated pulmonary artery (PA) and intubated trachea (TR).
Figure 3
Figure 3
EVLP dome for lung assessment (Vitrolife, Göteborg, Sweden).
Figure 4
Figure 4
Schematic illustration of the EVLP circuit. LA, left atrium; LAP, left atrial pressure; PA, pulmonary artery; PAP, pulmonary artery pressure; CDI, Terumo Cardiovascular Systems Corp, Ann Arbor, MI.
Figure 5
Figure 5
Chest x-ray at the beginning of EVLP (A) and at the end of assessment (B). It is clearly visible that EVLP ameliorates congestion of the lungs.
Figure 6
Figure 6
CT scan during EVLP assessment.
See this image and copyright information in PMC

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