LUNG TRANSPLANTATION: Edited by Jasleen KukrejaNormothermic machine perfusion of donor-lungs ex-vivo: promoting clinical adoptionGilmour, Jennya; Griffiths, Chelseaa; Pither, Toma; Scott, William E. IIIa; Fisher, Andrew J.a,bAuthor Information aNewcastle University Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University bInstitute of Transplantation, Newcastle Upon Tyne Hospitals, NHS Foundation Trust, Freeman Hospital, Newcastle Upon Tyne, UK Correspondence to Andrew J. Fisher, PhD, FRCP, Newcastle University Translational and Clinical Research Institute, 3rd Floor William Leech Building, Framlington Place, Newcastle Upon Tyne NE2 4HH, United Kingdom. Tel: +44 191 208 6000; e-mail: [email protected] Current Opinion in Organ Transplantation: June 2020 - Volume 25 - Issue 3 - p 285-292 doi: 10.1097/MOT.0000000000000765 Buy Metrics Abstract Purpose of review Lung transplantation offers the only realistic therapeutic option for patients with end-stage lung disease. However, this is impacted by a shortfall in availability of suitable donor-lungs. Normothermic machine perfusion of donor-lungs outside the donor body also known as ex-vivo lung perfusion (EVLP) offers a potential solution through objective assessment, reconditioning and treatment of donor-lungs initially deemed unsuitable for use. This review discusses key advances and challenges in the wider clinical adoption of this technology. Recent findings This review will summarize key research within the following areas: recent clinical trials utilizing EVLP, logistical challenges, EVLP protocol innovations, novel assessment methods and current research into therapeutic modulation of lung function during EVLP. Summary Normothermic machine perfusion of donor-lungs ex-vivo offers a promising platform to assess and modulate donor-lung quality prior to transplantation. Consensus on how and when to best utilize EVLP is yet to be reached, meaning that widespread clinical adoption of the technology has not yet become a reality. Further work is needed on agreed indications, perfusion protocols and organization of services before becoming a regularly used procedure prior to lung transplantation. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.