Ex-vivo lung perfusion and ventilation: where to from here?

Within the last decade, ex-vivo lung perfusion (EVLP) has become a widespread technology used for organ assessment and reconditioning within clinical transplantation. This review aims to offer insights toward future applications and developments in regards to its utility.

The intervention of EVLP is a well-tolerated method to effectively allow for extended preservation periods. The thoughtful usage of EVLP can therefore be used to optimize operating room logistics and progress lung transplantation toward becoming a more elective procedure. EVLP has also demonstrated itself as an excellent platform for targeted therapies. Prolonged perfusion achieved through further platform stability will allow for time-dependent molecular therapies. Lastly, EVLP allows for the opportunity to perform advanced diagnostics within an isolated setting. Sophistication of point-of-care technologies will allow for accurate predictive measures of transplant outcomes within the platform.

The future of EVLP involves usage of the system as a preservation modality, utilizing advanced diagnostics to predict transplant outcome, and performing therapeutic interventions to optimize organ quality. The generation of clinical data to facilitate and validate these approaches should be performed by transplant centers, which have acquired significant experience using EVLP within their clinical activity.