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A high-tech life-saving machine: How does EVLP work?
In the field of organ transplantation, especially lung transplantation, today’s technology has made it possible to give life to donated lungs that were once unusable! This amazing technology is the extracorporeal lung perfusion (EVLP) system. The machine works by temporarily preserving the lungs prior to transplantation by providing the necessary nutrients and oxygen to support the cellular metabolism of the donated lungs. Through a specially designed machine, EVLP can perfectly maintain lung activity in the human body, enhance the quality and function of the lungs, and enable doctors to fully evaluate them before transplantation.
Ex vivo lung perfusion not only prolongs the preservation time of donor lungs, but also repairs their damage, allowing more donors to receive successful transplants.
How EVLP works
The basic principle of EVLP is to continuously provide the lungs with carefully configured perfusion fluid through a professional machine after the donor's death and protect them through mechanical ventilation. This approach not only ensures the nutritional supply of lung tissue, but also reduces the impact of hypoxia and other environmental changes on lung tissue. By current standards, EVLP can extend the preservation time of donated lungs to 17 hours, which provides more hope for many donors.
The History of EVLP
The concept of EVLP originated in the 1930s, when medical scientists explored how to preserve and repair organs through perfusion technology. In 2001, Stig Steen's team from Lund University in Sweden successfully applied EVLP in the clinic to evaluate lungs from non-heartbeating donors. Their results demonstrate the effectiveness of this technique and provide a basis for further improvements.
EVLP Procedures and Protocols
Currently, there are several popular protocols in EVLP, including the Toronto Protocol, the Lund Protocol, and the Organ Care System Protocol. Each of these protocols has unique processes and features designed to best tailor and evaluate donated lungs for specific circumstances.
Toronto Agreement
The Toronto Protocol is one of the most widely used protocols and focuses on lungs from brain-dead and cardiac-dead donors who meet certain criteria. After an initial evaluation, qualified lungs will be connected to the EVLP system for perfusion, helping to improve oxygenation and overall lung function.
Lund Agreement
The Lund Protocol focuses on reevaluating donated lungs that were initially deemed unsuitable for transplantation, with the goal of improving the quality of these lungs to meet transplant standards.
Organ Care System Agreement
The Organ Care System Protocol is the first portable EVLP system that maintains lung functionality during transport, minimizing cold ischemia time and avoiding potential damage.
Advantages of EVLPEVLP technology can not only restore once-rejected donated lungs, but also improve the success rate after transplantation. By delivering anti-inflammatory drugs and antibiotics directly into the lungs, this technology can effectively reduce the inflammatory response and thus improve the lungs' ability to function. More importantly, EVLP also helps reduce the incidence of major post-transplant dysfunction, a life-threatening complication after lung transplantation.
Risks and Challenges
Although EVLP has great potential, there are still some risks and challenges. Problems such as inflammatory response and lung damage caused by mechanical ventilation may affect the success rate of transplantation. In addition, the economic cost of operating an EVLP system is relatively high, which also limits its wider use.
Nevertheless, the development of EVLP technology marks a major advancement in modern surgical medicine. Perhaps in the future there will be more innovations to further improve the success rate and survival rate of lung transplantation. What can this technology do for our medical care? What kind of changes does the system bring?
