Toronto EVLP System

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Ex Vivo can:

  1. Predict how well an organ will work after transplantation

  2. Helps the organ heal itself

  3. Allows surgeons time to treat and repair lungs

Ex Vivo facts:

  1. The UHN Transplant Program pioneered the use of this technology through our Toronto Ex Vivo Lung Perfusion System.

  2. Since 2012, the Transplant Program has offered lung transplants to 28% more patients due to the Toronto Ex Vivo Lung Perfusion System. This increase in care is not met by any other program in the world.

  3. ​The Ex Vivo perfusion system is now being refined for use with other organs, such as the liver and kidney.

Our research team in Toronto has developed the ex vivo lung perfusion or EVLP, a technique whereby a donor lung is placed in a protective dome and preserved at normothermic temperatures, which enables continued active cellular metabolism ex vivo. EVLP also creates, in effect, a time window in which novel lung repair and regeneration techniques can be applied to the donor lung prior to transplant.

In other words, it is a method of donor lung preservation, assessment, treatment, and repair of injured organs. EVLP allows donor lungs to be treated for at least 12h under protective physiological conditions. To date, more than 550 patients have been transplanted with donor lungs subjected to EVLP at our center.

 

Our lab has extensive expertise with adjunct therapies towards improving quality of injured donor organs during EVLP. We have previously shown that EVLP could be used as a platform to decrease donor lung inflammation associated with brain death, treat donor lungs affected with thromboembolic events, decrease cell death, and treat donor bacterial and virus infection. The EVLP is a seminal contribution to the lung transplant field that enabled the expansion of the donor lung pool worldwide and serves as a foundation for research in the preservation and regenerative repair of donor lungs ex vivo.

Currently, my lab is investigating several innovative treatment approaches to be used during EVLP system such as novel drugs to improve organ quality; increase preservation times; treat microbial infections (bacteria, fungi, hepatitis C, human cytomegalovirus, Epstein Barr Virus) and remove histo-blood group antigens from human donor lungs so they are suitable for ABO incompatible transplantation.