Strategies to prolong homeostasis of ex vivo perfused lungs

ObjectivesEx vivo lung perfusion provides an innovative method to assess and repair donor lungs. The current Toronto ex protocol can reliably reproducibly preserve lungs for 12 hours. A longer preservation time could enable the application of more advanced therapies rescue transplant. Our objective was achieve stable 24-hour normothermic perfusion.MethodsWe systematically examined 3 modifications perfusate administration in a large animal model. Pig were assigned 4 groups (n = 5 per group): (1) control; (2) continuous replacement perfusate; (3) modified feed, which used solution maintain osmolality by adjusting glucose sodium levels; (4) total parenteral nutrition, we added nutrition perfusate.ResultsOnly 1 control group completed perfusion. However, achieved group, feed group. significantly compared with (P .03). Lung function improved inflammatory cytokine production reduced control.ConclusionsModifications toward achieving homeostatic state extend up 24 Although these allow prolonged perfusion, further research will be required develop support beyond