Lung preservation

Pulmonary transplantation is now a clinical reality that offers hope to large numbers of patients with end-stage lung disease. Current methods of preserving pulmonary function allow for transplantation, but operation must be expeditious, and transportation time and operating time become critical factors in determining outcome. The ability to preserve lungs for longer time intervals could potentially allow for more widespread distribution of donor organs of unusual size or blood type, and could set the stage for more appropriate HLA matching between donor and recipient. Furthermore, a more thorough understanding of the pathophysiology of preservation injury will likely lead to a better understanding of the pathophysiology of other types of lung injury. In turn, this could increase the size of the pulmonary donor pool by allowing transplantation of lungs with suboptimal gas exchange function at the time of donor brain death. Finally, a more thorough understanding of lung metabolism and determinants of cellular viability in the lung would be useful for the potential application of the use of lungs from circulation-arrested cadavers for transplantation.