Development of experimental isolated lung perfusion model using surgically resected tumorous human lobes

Area of Science:

• Thoracic Surgery
• Transplant Research
• Pulmonary Medicine

Background:

• Ex vivo lung perfusion (EVLP) is established for donor lung assessment but less defined for translational research.
• Human cancerous lung tissue presents a unique model for evaluating EVLP methodology.
• This study investigates EVLP application in resected human cancerous lungs.

Purpose of the Study:

• To characterize the ex vivo lung perfusion (EVLP) methodology in human cancerous lung specimens.
• To evaluate physiological parameters during EVLP of cancerous lungs.
• To establish proof-of-concept for EVLP in translational lung research using cancerous tissue.

Main Methods:

• Ten human lung specimens (post-pneumonectomy or lobectomy) were included from 216 screened patients.
• Specimens underwent inflation, flushing with Perfadex®, and perfusion with Steen® solution.
• Physiological parameters were monitored using a blood gas analyzer throughout the perfusion period.

Main Results:

• EVLP experiments lasted a median of 159 minutes with stable functional parameters despite edema development.
• Elevated lactate levels did not correlate with functional deterioration (PaO2, PaCO2).
• Pneumonectomy specimens showed shorter warm ischemic times than lobectomy specimens.

Conclusions:

• Proof-of-concept EVLP in human cancerous lungs was characterized regarding physiological parameters.
• Effective edema management and defined endpoints are crucial for translational EVLP.
• Findings aim to guide future protocols and patient selection criteria for EVLP research.