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rom cold to warm: How does EVLP change the game for lung preservation
In the field of lung transplantation, an innovative preservation technique called Ex Vivo Lung Perfusion (EVLP) is redefining the way we store and evaluate donated lungs. This technology not only extends the preservation time of lungs, but also increases the availability of donated lungs that would otherwise be rejected, ultimately improving the chances of successful transplants.
Understand how EVLP works
EVLP is a mechanical perfusion technique designed to continuously maintain metabolic activity in donated lungs. The process takes place in a specially designed machine that mimics the conditions of a natural circulatory system and provides nutrients and oxygen in an environment close to human body temperature. As technology evolves, EVLP can allow for the re-evaluation and repair of donated lungs that were initially rejected, expanding the range of available lungs.
History and evolution
"The emergence of EVLP is not only a protective technology, but also a re-examination of donated organs. It also shows that our understanding of organ preservation and regeneration technology is constantly improving."
The conceptual origins of EVLP can be traced back to the 1930s, when scientists such as Alexis Carrel and Charles Lindbergh first explored the possibilities of organ perfusion. It was not until 2001 that Stig Steen and his team successfully implemented EVLP for clinical application for the first time at Lund University Hospital in Sweden, opening the door to the quality assessment of donated lungs.
Current EVLP Process
The existence of multiple protocols
There are currently three main EVLP protocols, including the Lund Protocol, the Toronto Protocol, and the Organ Care System (OCS Protocol). These protocols are designed to achieve the highest quality repair and evaluation for different types of donated lungs.
Toronto Agreement
"The Toronto protocol emphasizes safety and efficacy for donated lungs, making it one of the most popular EVLP protocols currently available."
The protocol was evaluated on lungs obtained from brain-dead and cardiac-dead donors. Its main goal is to improve poorly oxygenated lungs and revitalize lungs that are otherwise unsuitable for transplantation so that they can be successfully transplanted.
Lend Agreement
As the first efficient EVLP process, the Lund protocol focuses on repairing donated lungs that are initially judged to be unsuitable. Through this protocol, lungs that were once rejected have been re-evaluated and, in many cases, their function has improved and have been successfully transplanted.
Organ Care System Protocol
The OCS protocol is the first portable EVLP system capable of evaluating the function of donated lungs during transport. The system is designed to keep the donated lungs at human body temperature throughout the process, significantly reducing the risk of hypothermic ischemia.
Improve the success rate of transplantation
EVLP offers a promising opportunity to improve the survival and function of donated lungs. Studies have shown that lung transplantation using EVLP technology has improved short-term and long-term survival rates after surgery, which will undoubtedly have a positive impact on the future recovery and quality of life of transplant patients.
"EVLP is undoubtedly a game-changer for organ transplantation by improving the storage and transportation strategies for donated lungs, allowing lungs that would otherwise be rejected to be regenerated."
Risks and Challenges
Although EVLP has obvious advantages, its potential risks, such as lung inflammation and ventilation-induced lung damage, must also be considered during its implementation. In addition, economic burden is also a major challenge for EVLP. The required professional equipment and personnel training require investment, but the current medical insurance system's support for this is unclear.
Future Outlook
With the advancement of medical technology and the increase in transplantation needs, EVLP technology is expected to be further developed and applied. Ask yourself, could EVLP become the standard preservation and evaluation procedure for every donated lung in the near future, thus revolutionizing the future of lung transplantation?
