Department of Transplantation, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom.
Transplantation. 2013 Sep;96(6):509-18. doi: 10.1097/TP.0b013e318295eeb7.
There is a critical mismatch between the number of donor lungs available and the demand for lungs for transplantation. This has created unacceptably high waiting-list mortality for lung transplant recipients. Currently (2012) in the United Kingdom, there are 216 patients on the lung transplant waiting list and 17 on heart and lung transplant list. The waiting times for suitable lungs average 412 days, with an increasing mortality and morbidity among the patients on the lung transplant list. Ex vivo lung perfusion (EVLP) has emerged as a technique for the assessment, resuscitation, and potential repair of suboptimal donor lungs. This is a rapidly developing field with significant clinical implications. In this review article, we critically appraise the background developments that have led to our current clinical practice. In particular, we focus on the human and animal experience, the different perfusion-ventilation strategies, and the impact of different perfusates and leukocyte filters. Finally, we examine EVLP as a potential research tool. This will provide insight into EVLP and its future development in the field of clinical lung transplantation.
供体肺数量与肺移植需求之间存在严重不匹配。这导致肺移植受者的等待名单死亡率高得令人无法接受。目前（2012 年），英国有 216 名肺移植等待名单上的患者和 17 名心肺移植名单上的患者。合适肺的等待时间平均为 412 天，肺移植名单上的患者死亡率和发病率不断上升。离体肺灌注 (EVLP) 已成为评估、复苏和潜在修复不理想供体肺的一种技术。这是一个快速发展的领域，具有重要的临床意义。在这篇综述文章中，我们批判性地评估了导致我们目前临床实践的背景发展。特别是，我们专注于人类和动物的经验、不同的灌注-通气策略以及不同的灌注液和白细胞过滤器的影响。最后，我们研究了 EVLP 作为一种潜在的研究工具。这将深入了解 EVLP 及其在临床肺移植领域的未来发展。
