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Related Experiment Video

Updated: Aug 25, 2025

Method of Isolated Ex Vivo Lung Perfusion in a Rat Model: Lessons Learned from Developing a Rat EVLP Program
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Remote ex vivo lung perfusion at a centralized evaluation facility.

Jorge M Mallea1, Matthew G Hartwig2, Cesar A Keller3

  • 1Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic Florida, Jacksonville, Florida; Department of Transplantation, Center for Regenerative Medicine, Mayo Clinic Florida, Jacksonville, Florida.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|October 13, 2022
PubMed
Summary

A centralized lung evaluation system (CLES) using ex vivo lung perfusion (EVLP) feasibility study shows it can increase lung transplants. While initial primary graft dysfunction was higher, long-term survival outcomes were similar to conventional methods.

Keywords:
EVLPPGD3cold ischemia timedonation after cardiac deathlung transplant

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Area of Science:

  • Transplantation Medicine
  • Surgical Innovation
  • Organ Preservation

Background:

  • Limited utilization of donor lungs for transplantation in the US (only 23%).
  • Ex vivo lung perfusion (EVLP) offers potential for evaluating more donor lungs.
  • Barriers to EVLP adoption include resource and expertise limitations.

Purpose of the Study:

  • To assess the feasibility of a centralized lung evaluation system (CLES) for expanding access to EVLP.
  • To evaluate the outcomes of lung allografts assessed via EVLP using a CLES.

Main Methods:

  • A feasibility study involving 7 US transplant centers referring declined lungs to a dedicated EVLP facility with a CLES.
  • Remote monitoring of EVLP by transplant teams.
  • Comparison of CLES-assessed lungs with contemporaneous, conventionally preserved control lungs.

Main Results:

  • 66 allografts were successfully transplanted after EVLP via CLES, increasing transplant numbers.
  • Higher incidence of primary graft dysfunction grade 3 at 72 hours (PGD3-72 hours) in the CLES group (24%) versus controls (4%).
  • Similar 30-day and 1-year recipient survival rates between CLES and control groups (89% vs. 92%).
  • Increased total preservation time, hospital/ICU length of stay, and time to extubation in the CLES group.

Conclusions:

  • Remote EVLP using a CLES is a feasible approach to increase lung allograft utilization.
  • CLES-assisted EVLP leads to more lung transplants, despite a higher early PGD rate.
  • Long-term outcomes (30-day and 1-year survival) are comparable between CLES-EVLP and conventional transplantation.