The Present and Future of Lung Preservation

Abstract

Over the years, lung preservation strategies have evolved significantly, transitioning from intracellular to extracellular solutions. Notably, Perfadex, ET-Kyoto, and EP-TU solutions have become widely accepted. The inception of ex vivo lung perfusion (EVLP) and the adoption of 10 degrees preservation have substantially transformed lung transplantation procedures.

Yet, the journey towards optimal organ preservation continues. The ultimate goal is to substantially reduce cellular metabolism, mirroring a state of metabolic arrest. Such a state is observed in hibernation, where mammals like squirrels and bears reduce their basal metabolism to 1-25% of normal levels to survive harsh conditions. Recent advances demonstrate the possibility of pharmacologically inducing a similar hypometabolic state at the cellular level.

We delve into the potential of augmenting lung preservation duration by integrating hibernation-inducing agents into the extracellular fluid lung preservation solution and the EVLP perfusate. Our goal is to safely induce a hypometabolic state in solid organs, which may potentially redefine long-term preservation of organs.