[The development of ex vivo lung perfusion in lung transplantation]

The shortage of donor lung remains one of the major problem for lung transplantation. With the development of modern lung preservation and repair technique, increasing marginal lung donors have been re-assessed and finally utilized for transplantation. The ex vivo lung perfusion technique (EVLP) was designed and has been developed for evaluation and repair of the lung. Nowadays, the indication of EVLP and the standard of qualified donor lung have reached a consensus according to the foreign publications. The EVLP system could be classified into three categories: the Toronto technique, the Lund technique and Hannover-Madrid technique. The major differences between the Toronto technique and the other two technique are the open left atrium status, the use of Steen solution mixed with erythrocyte and the perfusion at flows correspondent to 100% of the donor predicted cardiac output. With the accumulating experience, researchers have tried to imply some drugs in the circulation, modify the ventilation gas and delivery of adenoviral vector gene in order to improve the lung quality. But these are still in the research phase. Recently, the portable EVLP device has been developed and the lung preservation, assessment and repair could be conducted during transportation. So it could prolong the preservation time and expand the transportation distance of donor lung.