Xenogeneic cross-circulation for extracorporeal recovery of injured human lungs

Nat Med. 2020 Jul;26(7):1102-1113. doi: 10.1038/s41591-020-0971-8. Epub 2020 Jul 13.

Abstract

Patients awaiting lung transplantation face high wait-list mortality, as injury precludes the use of most donor lungs. Although ex vivo lung perfusion (EVLP) is able to recover marginal quality donor lungs, extension of normothermic support beyond 6 h has been challenging. Here we demonstrate that acutely injured human lungs declined for transplantation, including a lung that failed to recover on EVLP, can be recovered by cross-circulation of whole blood between explanted human lungs and a Yorkshire swine. This xenogeneic platform provided explanted human lungs a supportive, physiologic milieu and systemic regulation that resulted in functional and histological recovery after 24 h of normothermic support. Our findings suggest that cross-circulation can serve as a complementary approach to clinical EVLP to recover injured donor lungs that could not otherwise be utilized for transplantation, as well as a translational research platform for immunomodulation and advanced organ bioengineering.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Lung Injury / blood
  • Acute Lung Injury / physiopathology
  • Acute Lung Injury / therapy*
  • Animals
  • Extracorporeal Circulation / methods
  • Humans
  • Lung / blood supply*
  • Lung / physiopathology
  • Lung Transplantation / methods*
  • Organ Preservation / methods*
  • Perfusion / methods
  • Swine
  • Tissue Donors