[How to increase availability of grafts in lung transplantion: ex vivo lung reconditioning - cardiac death donors - high emergency list].

Lung transplantation has become an established treatment for end-stage pulmonary failure refractory to medical management. However, the scarcity of lung grafts and the growing number of candidates has led to an increase in deaths among patients on waiting lists. Despite improvements in donor management, organ preservation, and the use of marginal and cardiac death donors, only about 20% of candidate lungs are currently being transplanted. A new ex vivo "reconditioning" technique is opening up new perspectives. Indeed, a significant number of rejected lungs can now be retrieved and transplanted with acceptable results. Given the longer storage times provided by this technique, transplantation can be programmed, with better surgical efficiency. A new mobile organ-care machine is currently under evaluation. In near future, a pilot laboratory will be created and dedicated to ex vivo reconditionning of all lung grafts before transplantation and grafts will be sent to lung transplant centers after immunologic cross-matching.