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Ex-vivo lung perfusion and ventilation

where to from here?

Ali, Aadila; Cypel, Marceloa,b

Current Opinion in Organ Transplantation: June 2019 - Volume 24 - Issue 3 - p 297–304
doi: 10.1097/MOT.0000000000000647
LUNG TRANSPLANTATION: Edited by Allan R. Glanville
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Purpose of review Within the last decade, ex-vivo lung perfusion (EVLP) has become a widespread technology used for organ assessment and reconditioning within clinical transplantation. This review aims to offer insights toward future applications and developments in regards to its utility.

Recent findings The intervention of EVLP is a well-tolerated method to effectively allow for extended preservation periods. The thoughtful usage of EVLP can therefore be used to optimize operating room logistics and progress lung transplantation toward becoming a more elective procedure. EVLP has also demonstrated itself as an excellent platform for targeted therapies. Prolonged perfusion achieved through further platform stability will allow for time-dependent molecular therapies. Lastly, EVLP allows for the opportunity to perform advanced diagnostics within an isolated setting. Sophistication of point-of-care technologies will allow for accurate predictive measures of transplant outcomes within the platform.

Summary The future of EVLP involves usage of the system as a preservation modality, utilizing advanced diagnostics to predict transplant outcome, and performing therapeutic interventions to optimize organ quality. The generation of clinical data to facilitate and validate these approaches should be performed by transplant centers, which have acquired significant experience using EVLP within their clinical activity.

aLatner Thoracic Surgery Research Laboratories

bDivision of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada

Correspondence to Marcelo Cypel, MD, M.Sc., Division of Thoracic Surgery, University Health Network, Toronto, ON, Canada. Tel: +1 416 3404800x5156; fax: +1 416 3403478; e-mail: Marcelo.Cypel@uhn.ca

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