Rosso Lorenzo, Zanella Alberto, Righi Ilaria, Barilani Mario, Lazzari Lorenza, Scotti Eleonora, Gori Francesca, Mendogni Paolo
Thoracic Surgery and Lung Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
J Thorac Dis. 2018 Jul;10(Suppl 20):S2423-S2430. doi: 10.21037/jtd.2018.04.151.
Lung transplantation is the only therapeutic option for end-stage pulmonary failure. Nevertheless, the shortage of donor pool available for transplantation does not allow to satisfy the requests, thus the mortality on the waiting list remains high. One of the tools to overcome the donor pool shortage is the use of lung perfusion (EVLP) to preserve, evaluate and recondition selected lung grafts not otherwise suitable for transplantation. EVLP is nowadays a clinical reality and have several destinations of use. After a narrative review of the literature and looking at our experience we can assume that one of the chances to improve the outcome of lung transplantation and to overcome the donor pool shortage could be the tissue regeneration of the graft during EVLP and the immunomodulation of the recipient. Both these strategies are performed using mesenchymal stem cells (MSC). The results of the models of lung perfusion with MSC-based cell therapy open the way to a new innovative approach that further increases the potential for using of the lung perfusion platform.
肺移植是终末期肺衰竭的唯一治疗选择。然而，可用于移植的供体库短缺，无法满足需求，因此等待名单上的死亡率仍然很高。克服供体库短缺的工具之一是使用肺灌注（体外肺灌注，EVLP）来保存、评估和修复原本不适合移植的选定肺移植物。如今，EVLP已成为临床现实，并且有多种用途。在对文献进行叙述性综述并审视我们的经验后，我们可以认为，改善肺移植结果并克服供体库短缺的机会之一可能是在EVLP期间移植物的组织再生以及受体的免疫调节。这两种策略均使用间充质干细胞（MSC）来实施。基于MSC的细胞疗法进行肺灌注模型的结果为一种新的创新方法开辟了道路，该方法进一步增加了肺灌注平台的应用潜力。
