Ex vivo lung perfusion and reconditioning.

Normothermic ex vivo lung perfusion can act as a platform for the evaluation and repair of donor lungs. An acellular hyperosmolar solution is perfused anterograde through the donor lungs at 40% of the estimated cardiac output. Following oxygenation of the perfusate by the lung, it passes through a hollow fiber oxygenator supplied with a hypoxic gas mixture to remove oxygen and to maintain physiological carbon dioxide levels. Flow through a heat exchanger to maintain normothermia and a leukocyte filter to remove demarginated leukocytes completes the circuit. Lung function can be measured by the difference in PO2 between the perfusate postlung and postmembrane and by physiological parameters. Utilization of this method of ex vivo donor lung evaluation should reduce concerns of primary graft dysfunction and increase utilization rates of donor lungs.