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Updated: Jun 4, 2026
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Isolated Lung Perfusion System in the Rabbit Model
Published on: July 15, 2021
Ex vivo lung evaluation and reconditioning
Paulo Manuel Pêgo-Fernandes1, Alessandro Wasum Mariani, Israel Lopes de Medeiros
1Department of Thoracic Surgery, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. paulopego@incor.usp.br
Summary
Ex vivo lung perfusion (EVLP) enhances oxygenation in marginal donor lungs, improving transplant suitability. This technique shows great potential to increase lung availability and reduce wait times for patients.
Area of Science:
- Cardiovascular and Respiratory System Research
- Transplantation Medicine
- Organ Preservation and Evaluation
Background:
- Lung transplantation is limited by the low suitability rate (15%) of potential donor lungs.
- Marginal and unacceptable donor lungs often fail to meet transplantation criteria.
- Ex vivo lung perfusion (EVLP) offers a method for evaluating and reconditioning these lungs.
Purpose of the Study:
- To report the functional evaluation of twelve donor lungs deemed unacceptable for transplantation using EVLP.
- To assess the efficacy of EVLP in improving the quality of marginal donor lungs.
- To explore the potential of EVLP to increase lung donor availability.
Main Methods:
- Donor lungs were perfused ex vivo using Steen Solution, an extracellular fluid with high colloid osmotic pressure.
- A membrane oxygenator maintained perfusate blood gas levels, while lungs were rewarmed, reperfused, and ventilated.
- Evaluation included assessments of oxygenation capacity, pulmonary vascular resistance (PVR), and lung compliance (LC).
Main Results:
- Arterial oxygen pressure significantly increased from 193.3 mmHg to 495.3 mmHg during EVLP (at 100% inspired oxygen).
- After 1 hour of EVLP, mean pulmonary vascular resistance was 737.3 dynes/sec/cm5.
- Mean lung compliance was measured at 42.2 ml/cmH2O after 1 hour of EVLP.
Conclusions:
- The EVLP model effectively improves the oxygenation capacity of marginal lungs unsuitable for transplantation.
- EVLP demonstrates significant potential to expand the pool of available lung donors.
- This technique may contribute to reducing lung transplant waiting list times.
