Introduction

A quick guide to Ex Vivo Lung Perfusion (EVLP)

This section briefly summarizes the EVLP procedure following the Toronto protocol, currently the most widely adopted protocol in North America and Europe. Other similar protocols can be used but virtually all EVLP protocols employ STEEN Solution™ (with or without red blood cells) as the ex vivo perfusate.

EVLP can be performed using either the XPS™ fully integrated machine which incorporates all components required for normothermic EVLP or by using the manual method employing off-the-shelf cardiac by-pass equipment.

EVLP offers clinicians and transplant teams an ideal setting for donor evaluation and lung treatment. The flexibility of XPS™ permits adjustment to preferred clinical protocol as well as flow and ventilation adjustments. Using the XPS™ fully integrated machine provides a better standardized and reproducible approach to EVLP than employing a manual technique.

EVLP Fundamentals

Maintenance of the organ in tissue culture-like conditions

  • Adequate support of metabolism by providing nutrients and facilitating physiologic gas exchange
  • Low stress, lung protective strategy
  • Maintenance of alveolar/blood barrier integrity
  • Extensive functional organ assessment

EVLP as a tool to expand your donor organ pool

Lung transplantation has become the mainstay of therapy for patients suffering from end-stage lung disease refractory to medical management. However, the number of patients listed for lung transplantation largely exceeds the donors available. Currently only 15 to 20% of the lungs that are offered from brain dead donors are used; while 80% of the remaining donor lungs are rejected by the transplant programs primarily due to “Poor Organ Function.”

Normothermic ex vivo lung perfusion (EVLP), assessment and evaluation of poorly functioning donor lungs permits a more rational utilization of potentially acceptable organs which are currently often discarded despite the relatively reversible nature of their imperfections. The ultimate objective of the EVLP procedure is to expand the donor organ pool and thus reduce or possibly eliminate mortality and morbidity on the transplant waiting list.

A video introduction to EVLP

Listen to Dr Cantu explaining the concept of EVLP.

A video introduction to EVLP

Listen to Dr Cantu explaining the concept of EVLP.

  • EVLP with XPS™

    • XPS Disposable Kit including all components needed for one EVLP procedure • Gas mix

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  • EVLP with manual method

    • Hardware/Software • STEEN Solution™ • Disposables • Tubing • Gas mix

    Read more