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Ventilation during ex vivo lung perfusion, a review
Sue A Braithwaite1, Elise van Hooijdonk2, Niels P van der Kaaij2
1Department of Anesthesiology, University Medical Center Utrecht, Q04.2.317, Postbus 85500, Utrecht 3508, GA, the Netherlands.
Transplantation Reviews (Orlando, Fla.)
|April 26, 2023
Summary
Ventilation during ex vivo lung perfusion (EVLP) can harm donor lungs, especially marginal ones. This review explores protective ventilation strategies to minimize lung injury during EVLP.
Area of Science:
- Transplantation immunology
- Thoracic surgery
- Pulmonary medicine
Background:
- Standard ventilation strategies during ex vivo lung perfusion (EVLP) may cause lung injury.
- This injury is particularly concerning for marginal lung allografts.
- Lung injury during EVLP is a complex process influenced by multiple factors.
Purpose of the Study:
- To review the impact of ventilation on donor lungs during EVLP.
- To propose a framework for developing protective ventilation techniques.
Main Methods:
- Literature review focusing on ventilation strategies and lung injury in EVLP.
- Analysis of factors contributing to EVLP-induced lung injury.
Main Results:
- Positive pressure ventilation can induce stress and strain on lung tissue.
- Altered lung tissue properties in EVLP can exacerbate ventilation-induced injury.
- Pre-existing allograft injury can increase susceptibility to further damage during EVLP.
Conclusions:
- Protective ventilation is crucial to mitigate lung injury during EVLP.
- Developing tailored ventilation strategies is necessary for optimizing lung allograft viability.
- Further research into protective ventilation frameworks is warranted.
