Normothermic Perfusion of Donor Marginal Lungs with the Organ Care System Lung: Clinical and Morphologic Evaluation

TODAY, ORGANshortageisthemainlimitingfactortothe widespread applicationoflungtransplant(LT).Only20%of multiorgandonorsaresuitableforlungretrievalduetodifferent causes suchastrauma,pneumonia,andneurogenicedema. Ex vivolungperfusion(EVLP)isanextendedlungassess- ment andconditioningtechniquefordamageddonorlungs.1 However, asanon-transportabledevice,itisperformedonlyat the recipienthospital,thusavoidingpossibledamagethatcould occur duetocoldischemiaduringgrafttransport. The OrganCareSystem(OCS)Lung(Transmedics,And- over, MA)isanewportableEVLPtechnologythatincludesthe benefits ofEVLP,startingitseffectsinthedonorhospital, reducing inthiswaythecoldischemictime(Fig 1).2 According to theINSPIREtrial,theOCSLunghasbeenmostlyusedfor ideal organpreservation,andveryfewcasesofmarginallung reconditioning havebeenreported.3–5 To date,noclinicalcaseshavebeenreportedonclinicaland functional lungperformancewithtissueevaluation.The authors presenttheir first caseofmarginallungreconditioning with theOCSLungsystem.