LUNG PRESERVATION - A REVIEW OF CURRENT PRACTICE AND FUTURE-DIRECTIONS

During the past 10 years, pulmonary transplantation has emerged as a s uccessful mode of surgical therapy for suitable patients with end-stag e lung disease. Current preservation techniques of donor lungs for sub sequent transplantation include core-cooling and single flush perfusio n. The relative merits of these are described. These methods are essen tially restricted to 6 hours of ischemia. Research in lung preservatio n is aimed not only at extending the safe period of ischemia but also at improving the quality of preservation. Areas of interest include th e ideal composition of the perfusate, relevant pharmacologic additives , and the best conditions for preservation and harvesting. Advantages and disadvantages of the various animal models are listed in addition to the methods used in assessing the quality of preservation. There ha ve been major advances in experimental lung preservation during the pa st 10 years, and we are possibly on the threshold of incorporating som e of these into clinical practice. Among the most important are the ad option of colloid-based perfusates, the more widespread use of free ra dical scavengers, and the use of leukocyte depletion.