Ex Vivo Lung Perfusion (EVLP)
Use of EVLP to rehabilitate donor lungs for transplantation
PI: Irving Kron, MD and Victor Laubach, PhD
In 2001, the first human lung transplant from a non-heart beating donor (NHBD) after a failed resuscitation was reported. In this case, the lung was perfused ex vivo with an extracellular colloid solution called Steen solution™, which reproduces physiologic conditions for support of donor lungs. This technique, known as ex vivo lung perfusion (EVLP), has been used for both assessment and reconditioning of marginal donor lungs.
One of our current projects, funded by the National Institutes of Health, applies EVLP as a platform for pharmacologic delivery of A2AR agonist to test the hypothesis that EVLP with concomitant A2AR agonist treatment will rehabilitate NHBD lungs for successful transplantation. We are using our pre-clinical porcine lung transplant model to test this hypothesis, and we are also evaluating whether marginal human donor lungs, which are rejected for transplantation, can be rehabilitated in a similar fashion. In addition, we are testing the limits on how long donor lungs can be preserved prior to tranplant. A combination of cold, static preservation with EVLP might extend donor lung preservation up to 24 hours or longs. We believe that these therapeutic applications of A2AR agonist using EVLP could greatly increase the donor lung pool size, thus translating to many lives saved by improving post-transplantation outcomes and reducing donor wait list times.
Below are a few photos of our EVLP team harvesting a donor pig lung and preparing it for EVLP:
Lungs undergoing EVLP: