Normothermic Ex Vivo Lung Perfusion: A Review of the Toronto Protocol

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Aadil Ali


ex vivo lung perfusion, lung preservation, lung transplantation, lung assessment


Traditional methods of lung preservation include cold storage of lungs on ice prior to transplantation. Previous reports have identified deleterious outcomes with regards to prolonged cold ischemic time. Herein, a novel technique has been developed to perfuse lungs at normothermia. This review highlights a team in Torontos experience with developing and utilizing this system known as normothermic ex vivo lung perfusion (EVLP). EVLP allows for the assessment of marginal lungs and for reconditioning through therapeutic intervention. Various clinical studies have shown equivalent post-transplant outcomes when using the system on lungs that would have initially been declined for transplantation. EVLP ultimately expands available donor lungs for transplantation and its potential is addressed in this review.