Interventions to Improve the Conduct of Ex Vivo Lung Perfusion

• Author / Creator

  Buchko, Max

• Lung transplant remains the gold standard therapy for end-stage lung disease. As medical therapy continues to improve, though, the number of patients reaching stable end-stage lung disease continues to increase. Despite increasing need for suitable lung grafts, the number of donors remains stable. One of the major issues regarding organ availability is organ utilization. Currently, only 30% of lungs offered for donation are actually transplanted. Ex vivo lung perfusion (EVLP) is a developing technology, whereby the lungs are harvested and connected to a circuit which continually perfuses and ventilates the lungs. This allows the lungs to be reconditioned and evaluated outside the inflammatory milieu of the donor’s body. EVLP has been shown to improve utilization rates and allows for transplantation of marginal or extended criteria donor lungs. Despite its expanding clinical use, several key characteristics of machine perfusion remain untested. The objective of this thesis is to develop strategies for the improvement of EVLP. These include the development of a low-cost perfusate alternative, the development of a system for perfusate dialysis in EVLP to improve ionic homeostasis in prolonged EVLP, extension of preservation times beyond current thresholds, and to determine whether metabolic supplementation improves graft function in EVLP. The results of this thesis may be used to reduce costs and improve access to EVLP, as well as, elucidate the requirements of donor lung grafts during machine perfusion, especially during prolonged preservation. By continuing to optimize and improve EVLP, there lies the potential to further increase utilization rates among the current donor pool and improve outcomes in patients with end-stage lung disease.

• Subjects / Keywords

  • ex vivo lung perfusion

• Graduation date

  Fall 2019

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-6sv3-f671

• License

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