Enhanced Donor Lung Viability During Prolonged Ex Vivo Lung Perfusion Using ECMO Technology

Area of Science:

• Cardiovascular and Respiratory System Science
• Transplantation Science
• Biomedical Engineering

Background:

• Donor organ shortage is a critical barrier to lung transplantation.
• Ex vivo lung perfusion (EVLP) is a technique to assess and potentially improve donor lungs.
• Extracorporeal membrane oxygenation (ECMO) technology can be adapted for mobile EVLP circuits.

Purpose of the Study:

• To evaluate the safety and efficacy of a cellular-based EVLP system.
• To assess continuous cytokine removal during prolonged EVLP.
• To investigate the application of bronchodilators in EVLP.

Main Methods:

• Development of a mobile EVLP circuit using ECMO technology.
• Utilized 29 porcine lungs (aged 6-18 months, 93 ± 13.1 kg).
• Compared EVLP with and without a Cytosorb cartridge for cytokine removal, and with bronchodilator administration versus a control solvent.

Main Results:

• Whole blood-based perfusate with continuous ultrafiltration proved straightforward and efficient for up to 24 hours.
• Continuous cytokine removal significantly improved organ quality over 24 hours of EVLP.
• Bronchodilator administration effects require further investigation.

Conclusions:

• Mobile EVLP using ECMO is a feasible approach for lung preservation.
• Continuous cytokine removal is effective in enhancing donor lung quality during EVLP.
• Further research is needed to optimize EVLP protocols, including bronchodilator use.