Current strategies in lung preservation.

Current methods of lung preservation allow for effective, expeditious transplantation as a treatment for end-stage pulmonary disease. However, the utilization of hypothermia, hyperkalemia, and pulmonary artery distension as a single rapid flush for perfusion is less than ideal. All these interventions result in increased pulmonary vascular resistance and suboptimal preservation of lung function. The ability to preserve lungs for longer time intervals and with less risk of tissue injury would provide significant advantages. There would be a greater likelihood that rare size or blood types could find matches by enlarging the area of organ distribution. Optimal preservation would also improve the perioperative outcomes in regard to primary graft failure and subsequently reduce the later complication of chronic rejection and graft lung dysfunction. Finally, through a better understanding of the mechanisms of lung injury during preservation and by developing means to limit the injury, it would be possible to utilize organs from donors that at this time would not be considered optimal. This would increase the donor pool without compromising the recipient's outcome.