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Ex Vivo Lung Perfusion: Promises and Reality

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Contemporary Lung Transplantation

Part of the book series: Organ and Tissue Transplantation ((OTT))

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Abstract

Ex vivo lung perfusion (EVLP) has been utilized in clinical practice for over a decade. The technique and specific devices of this emerging technology are well established and described in the literature. However, these standardized techniques have not been implemented in transplant institutes throughout the world, and only a few, large-volume centers have been utilizing EVLP to increase the donor pool because of its technical difficulty. Additionally, most transplant surgeons have high hopes that EVLP will improve early and long-term posttransplant outcomes in lung transplant recipients. Improved outcomes have not yet been demonstrated, however. This chapter describes the technical details of EVLP step-by-step, points out potential technical pitfalls, reviews the results of clinical studies and national and international clinical trials to evaluate the role and impact of EVLP in current practice, and considers the future of EVLP.

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Acknowledgments

We thank Dr. Shannon L. Wyszomierski for editing the book chapter.

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Authors and Affiliations

  1. Division of Lung Transplant and Lung Failure, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Kentaro Noda

  2. Division of Lung Transplant and Lung Failure, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Pablo G. Sanchez

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  1. Kentaro Noda
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Correspondence to Pablo G. Sanchez .

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Editors and Affiliations

  1. PALERMO, Palermo, Italy

    Alessandro Bertani

  2. PALERMO, Palermo, Italy

    Patrizio Vitulo

  3. PALERMO, Palermo, Italy

    Paolo Antonio Grossi

Electronic Supplementary Material

LA back flow in lungs on EVLP with the Lund protocol. Swine lungs were placed on an LS-1 machine and perfused with 100% of cardiac output. The flow coming back from the pulmonary vein makes a fountain shape of perfusate and creates positive pressure in the pulmonary vein. (This video was kindly provided by Mr. Rodney Jones (XVIVO Perfusion) and is used with permission) (MP4 7447 kb)

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Noda, K., Sanchez, P.G. (2021). Ex Vivo Lung Perfusion: Promises and Reality. In: Bertani, A., Vitulo, P., Grossi, P.A. (eds) Contemporary Lung Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-20788-9_23-1

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