Artificial lungs--Where are we going with the lung replacement therapy?

Area of Science:

• Biomedical Engineering
• Regenerative Medicine
• Pulmonary Medicine

Background:

• Lung transplantation is limited by donor organ scarcity, necessitating alternative treatments for advanced lung failure.
• The coronavirus disease 2019 pandemic highlighted the need for robust respiratory support systems.
• Existing mechanical devices face persistent challenges including infection, bleeding, thrombosis, cost, and patient quality of life.

Purpose of the Study:

• To review current developments and future research in artificial lung technologies and tissue engineering for refractory lung disease.
• To discuss the persistent challenges and future directions in respiratory assist devices.
• To explore strategies for repairing, restoring, replacing, or regenerating lung function.

Main Methods:

• Review of ongoing advancements in respiratory assist devices, focusing on hollow fiber membrane gas exchangers and microchannel-based systems.
• Exploration of tissue engineering and cell-based technologies for developing bioartificial lungs.
• Analysis of engineering and biological progress in artificial lung technologies.

Main Results:

• Engineering improvements are enabling longer-term wearable artificial lung systems, serving as a bridge to transplantation.
• Microchannel-based devices offer potential for biomimetic and intracorporeal implantation.
• Tissue engineering is advancing bioartificial lungs with native organ-like properties.

Conclusions:

• Continued progress in both engineering and biology is crucial for developing advanced artificial lungs.
• The ultimate goal is a durable, implantable artificial lung for destination therapy in lung failure.
• Addressing challenges in current devices and pursuing regenerative approaches are key to future lung support.