History in the making: 10 years on after the first transplantation of “marginal” lungs subjected to EVLP

Although the first pioneering papers on ex-vivo lung perfusion (EVLP) were published by Prof Stig Steen from Lund, Sweden in 2001 and 2003, the first human transplantation of a rejected donor lung reconditioned by EVLP (also from Lund) was not published until 2007. (Steen et al, 2007). Over the intervening 10 years, the Lund group have followed the 21 patients (6 EVLP and 15 conventional) who received lungs in 2006 / 2007 to assess comparative outcomes.

Pulmonary function was assessed by spirometry and 6-minute walking test (6MWT) at 3, 6, 12 months and annually. No difference in median FEV1 nor 6 MWT was found for EVLP vs conventional lung transplants (p>0.05). Survival curves for patients with a limited survival up to 5 years and overall survival up to 10 years also revealed no difference between lungs subjected to EVLP and conventional lungs – further evidence that EVLP of initially-rejected lungs yields lungs that are well comparable with conventional lungs.


7. Steen S, Ingemansson R, Eriksson L, Pierre L, Algotsson L, Wierup P, Liao Q, Eyjolfsson A, Gustafsson R, Sjöberg T. First human transplantation of a nonacceptable donor lung after reconditioning ex vivo. Ann Thorac Surg. 2007 Jun;83(6):2191-4 (link to abstract).

8. Fakhro M et al, Ex-vivo Lung Perfusion – 10 Year Follow-up of the First Performed Double LTX With Marginal Donor Lungs Evaluated Using EVLP. J Heart Lung Transplant. 37, 45, April 2018, Suppl S149 (link to abstract).

Xvivo Insights PB-2018-05-20