Donor Lung Preservation

Cold storage lowers cellular metabolism and oxygen demand while the lungs remain outside the body. Specialized preservation solutions support this low-activity state during the interval between organ recovery and transplantation. By limiting metabolic stress during storage, the approach helps reduce injury that could otherwise impair graft function after implantation.

Ischemia-reperfusion injury is an important concern because preservation occurs while the organ is outside the body and normal circulation is interrupted. Effective storage or perfusion strategies aim to limit the damage associated with this interval and the restoration of blood flow after transplantation. Reducing that injury can support more reliable graft function.

Ex vivo lung perfusion uses a warm, oxygenated solution that circulates through the donor organ, rather than maintaining it in a cold, low-metabolism state. This circulation can support direct assessment of the lungs and, in some cases, reconditioning. The two approaches therefore provide different preservation environments during transplant preparation.

Suitability depends on whether preservation maintains lung condition well enough to support graft function after transplantation. Ex vivo assessment can provide additional information when an organ initially appears unsuitable, while conventional cold storage maintains the organ during coordination and transport. These strategies help clinicians make better-informed decisions about donor-lung use.

The process begins with organ recovery, followed by preservation outside the body while transplantation is arranged. Lungs may be maintained using cold storage and a specialized solution, or connected to an ex vivo lung perfusion system with a warm, oxygenated circulating solution. The selected approach supports transport, evaluation, or possible reconditioning before implantation.

Teams may consider ex vivo lung perfusion when additional evaluation is valuable, particularly for lungs that initially appear unsuitable for transplantation. The system circulates a warm, oxygenated solution through the organ, allowing assessment and, in some cases, reconditioning. This can expand donor-lung utilization while providing more information before a final transplant decision.