AUTHOR=Chilvers Nicholas J. S. , Gilmour Jenny , Brown Marnie L. , Bates Lucy , Pang Chong Yun , Pauli Henning , Dark John , Fisher Andrew J. 

TITLE=A Split-Lung Ex Vivo Perfusion Model for Time- and Cost-Effective Evaluation of Therapeutic Interventions to the Human Donor Lung

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12573

DOI=10.3389/ti.2024.12573

ISSN=1432-2277

ABSTRACT=In the face of an ongoing shortage of donor lungs, ex vivo lung perfusion (EVLP) offers the opportunity for objective assessment and potential therapeutic repair of marginal organs. There is a need for robust research into EVLP interventions to increase the number of transplantable organs. Use of human lungs declined for transplant for these studies is preferable to animal organs and indeed essential if clinical translation is to be achieved. However, experimental human EVLP is time-consuming and expensive which limits the rate at which promising interventions can be assessed. A split-lung EVLP model allowing stable perfusion and ventilation of two single lungs from the same donor offers advantages scientifically, financially and in time to yield results. Identical parallel circuits allow one to receive an intervention and the other to act as a control, removing inter-donor variation between study groups. Continuous haemodynamic and airway parameters are recorded and blood gas, perfusate and tissue sampling facilitated. Pulmonary oedema is assessed directly using ultrasound, and indirectly using wet:dry ratio of lung tissue. Evans blue dye leak into tissues can quantify vascular endothelial permeability. The split-lung ex vivo perfusion model, offers a cost-effective, reliable platform for testing therapeutic interventions with relatively small sample sizes.