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Updated: Feb 14, 2026

Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
Published on: February 14, 2022
High positive end-expiratory pressure during ex vivo lung perfusion: recruiting rejected donor lungs
Kamal S Ayyat1,2,3, Toshihiro Okamoto1,2, Hiromichi Niikawa1,2
1Department of Pathobiology, Cleveland Clinic, Cleveland, OH, USA.
Abstract:
We present an innovative method for recruiting clinically rejected donor lungs using positive end-expiratory pressure titration during ex vivo lung perfusion. Currently, ex vivo lung perfusion protocols are using a standard positive end-expiratory pressure of 5 cmH2O for all cases. Individualized positive end-expiratory pressure titration combined with recruitment manoeuvres has been found to significantly improve pulmonary functions in mechanically ventilated patients. Applying this concept to ex vivo lung perfusion may be helpful in increasing the conversion rate for transplant suitability.
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