Ex-vivo lung perfusion: the model for the organ reconditioning hub.

PURPOSE OF REVIEW: Lung evaluation and reconditioning by ex-vivo lung perfusion (EVLP) is becoming increasingly established. We review strategies for broader implementation of this technology to transplant centers worldwide.

RECENT FINDINGS: The organ reconditioning hub model is a viable strategy for disseminating EVLP to small and large transplant centers given the well tolerated prolongation of preservation time afforded by EVLP. Regulatory and process issues remain hurdles to be overcome.

SUMMARY: EVLP demonstrates promise to increase lung utilization. Organ reconditioning hubs appear to be an efficient method of delivering this promise to all transplant centers, not necessarily only the largest ones. Organ allocation processes will need to adapt to this new paradigm of organ preservation and evaluation. Moreover, regulatory issues will need to be deliberated by the transplant community.