[Frontiers in Bioscience E4, 2226-2232, January 1, 2012]

Isolated lung perfusion

Marcelo Cypel1, Shaf Keshavjee1

1Division of Thoracic Surgery and Lung Transplant Program. Toronto General Hospital, 190 Elizabeth St.  RFE 1-408, Toronto, ON, M5G 2C4, Canada

TABLE OF CONTENTS

1. Abstract
2. Ex vivo lung perfusion (EVLP)
2.1. Introduction and experimental work to date
2.1.1. Toronto technique of EVLP
2.1.1.1. Clinical experience with EVLP
2.1.1.1.1. Pharmacological interventions during EVLP
2.1.1.1.1.1. Molecular interventions during EVLP
3. In vivo lung perfusion (IVLP) for Treatment of Cancer Metastases
3.1. Introduction and rationale
3.1.1 ..Experimental studies of IVLP
3.1.1.1. Clinical studies of IVLP
3.1.1.1.1. Other techniques for delivery of high dose chemotherapy to the lungs
4. Conclusions and future perspectives
5. References

1. ABSTRACT

Isolated lung perfusion (ILP) has been historically used as a method to study basic lung physiologic concepts using animal models. More recently, ILP has been applied in lung transplantation and thoracic oncology. In lung transplantation, ILP has been used to assess physiological integrity of donor lungs after the organ is removed from the donor. This procedure is called Ex vivo Lung Perfusion (EVLP), and it has also been proposed as a method for active treatment and repair of injured unsuitable donor organs ex vivo. In oncology, ILP is an attractive method to deliver high dose chemotherapy to treat pulmonary metastatic disease. Since the lung vasculature is isolated in vivo, this technique is called in vivo lung perfusion (IVLP). This review will focus on the rationale, technical aspects, experimental and clinical experience of EVLP and IVLP. A perspective on the future use of these techniques is described.