MetaboSense: An Integrated Quantum Dot-Mediated Aptamer Assay and Modular Microfluidic Platform for Continuous...

Organ transplantation provides a life-saving intervention for patients with end-stage lung disease; however, access to this treatment remains limited by the shortage of donor organs. Ex vivo lung perfusion (EVLP) is a platform that enables surgeons to assess extended-criteria for donor lungs prior to transplantation and has safely expanded the donor pool. Yet current EVLP biochemical assessments rely on intermittent manual sampling and fail to capture dynamic metabolic changes. Here we present MetaboSense, a first-of-its-kind microfluidic platform for continuous, real-time, multiplexed monitoring of glucose and lactate-key metabolites that report on donor lung metabolism-during EVLP. The system integrates a bead-based, quantum dot-mediated aptamer assay with modular microfluidics for in-line biomarker measurement. MetaboSense achieves limits of detection of 0.74 mM (glucose) and 1.19 mM (lactate) with analytical precision (R² > 0.97). Clinical validation across eleven EVLP cases demonstrates strong correlation with gold-standard arterial blood gas measurements. In-line deployment within an EVLP circuit during perfusion of porcine lungs confirms MetaboSense's ability to track metabolite fluctuations with 60-s temporal resolution. This platform eliminates labor-intensive sampling and provides unprecedented granularity in lung metabolomics during EVLP, representing an important step toward real-time EVLP analytics and improved organ selection and transplant outcomes.