Ex Vivo Lung Perfusion: Promises and Reality

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.