Rehabilitation of marginal human donor lungs by EVLP
PI: Irving Kron, MD
Lungs have traditionally been harvested from individuals who have died after meeting the criteria for brain death (i.e. donation after brain death [DBD] donors). To help overcome the shortage of donor lungs, many programs now utilize a limited number of marginal or extended criteria DBD donor lungs, and some have also begun using lungs from donation after cardiac death (DCD) donors or non-heart beating donors (NHBD). However, the main obstacle in the expanded use of NHBD lungs lies with the severe IR injury of the lung due to the warm ischemia, which is often lengthy or unknown (i.e. uncontrolled NHBD lungs). Despite these hurdles, the NHBD lung pool is becoming substantial, and the largest percentage increase in multi-organ donors in recent years has been in the NHBD category, which will significantly impact organ use in the future.
In addition to our porcine EVLP and lung transplant model, we are also evaluating marginal human donor lungs via EVLP and adenosine A2A receptor agonist therapy. Through a partnership with LifeNet Health®, we are obtaining and evaluating marginal and previously rejected human donor lungs. Dr. Christine Lau, MD is instrumental in the procurement and use of these human lungs. We have already begun our first set of human donor lungs, with the hope that EVLP with A2A receptor therapy will significantly improved the function of these lungs while reducing edema and inflammation (immune cell activation and cytokine production).
Here is a photo of a set of human lungs on our EVLP circuit: