To overcome the donor shortage in lung transplantation, it is crucial to use the marginal donor lungs and lungs from cardiac-death donors, which are supposed to be actually or potentially damaged. To utilize these damaged donor lungs safely, it is important to evaluate such donor lungs objectively before transplantation. Recently, ex vivo lung perfusion (EVLP) has been introduced internationally and several clinical trials are also ongoing in western countries. On the other hand, we have investigated the quality of donor lungs using EVLP and tried to treat the donor lungs during EVLP before lung transplantation. Herein, we would like to demonstrate our findings and discussed the future of EVLP. In fact, we established small animal EVLP in 2003 and large animal EVLP in 2006. We also established several injured lung models and performed various experiments using EVLP, proving that damaged donor lungs could be treated with several drugs using EVLP.
