Xenogeneic cross-circulation for extracorporeal recovery of injured human lungs.

Nature Medicine volume 26, pages1102–1113(2020)

Hozain A E, O’Neill J D, Pinezich M R, Tipograf Y, Donocoff R . Cunningham K M, Tumen A, Fung K, UkitaR, Simpson MT, Reimer J A, Ruiz E C, Queen D, Stokes J W, Cardwell N L, Talackine J, Kim J, Snoeck H-W, Chen Y-W, Romanov R, Marboe C C, Griesemer A D, Guenthart B A, Bacchetta M, Vunjak-Novakovic G https://doi.org/10.1038/s41591-020-0971-8

Patients awaiting lung transplantation face high wait-list mortality, as injury precludes the use of most donor lungs. Although ex vivo lung perfusion (EVLP) is able to recover marginal quality donor lungs, extension of normothermic support beyond 6 h has been challenging. Here we demonstrate that acutely injured human lungs declined for transplantation, including a lung that failed to recover on EVLP, can be recovered by cross-circulation of whole blood between explanted human lungs and a Yorkshire swine. This xenogeneic platform provided explanted human lungs a supportive, physiologic milieu and systemic regulation that resulted in functional and histological recovery after 24 h of normothermic support. Our findings suggest that cross-circulation can serve as a complementary approach to clinical EVLP to recover injured donor lungs that could not otherwise be utilized for transplantation, as well as a translational research platform for immunomodulation and advanced organ bioengineering

Nat Med 26, 1102–1113 (2020). https://doi.org/10.1038/s41591-020-0971-8