Journal of Heart and Lung Transplantation最新文献

{"title":"Reasons for donor heart offer refusal in the United States: Results from 14,132 transplant clinician surveys in the Donor Heart Study","authors":"Brian Wayda MD, MPH ,&nbsp;Helen Luikart RN ,&nbsp;Yingjie Weng MHS ,&nbsp;Shiqi Zhang MS ,&nbsp;Nikole Neidlinger MD ,&nbsp;R. Patrick Wood MD ,&nbsp;Javier Nieto MD ,&nbsp;Bruce Nicely RN, MSN ,&nbsp;John Belcher BS ,&nbsp;Tahnee Groat MPH ,&nbsp;Darren Malinoski MD ,&nbsp;Jonathan Zaroff MD ,&nbsp;Kiran K. Khush MD, MAS","doi":"10.1016/j.healun.2025.02.1698","DOIUrl":"10.1016/j.healun.2025.02.1698","url":null,"abstract":"<div><h3>Background</h3><div>Despite a shortage of donors for heart transplant (HT) in the United States, most potential donor hearts are discarded. We evaluated the reasons why and their temporal and geographic variation using a US-wide survey of HT clinicians.</div></div><div><h3>Methods</h3><div>The Donor Heart Study enrolled 4,333 adult potential heart donors in United States from 2015-2020. Separately by donor, each HT center that refused an offer for that donor was surveyed on their reason(s) for refusal. We measured the prevalence of 28 distinct donor-unrelated reasons for refusal and characterized their temporal and geographic variation.</div></div><div><h3>Results</h3><div>Of 14,132 surveys collected—each representing a single declined donor offer—donor-specific, recipient, and mismatch issues were cited in 49.3%, 24.3%, and 38.0%, respectively. Among surveys citing only donor-specific issues, the most common were age, coronary artery disease, left ventricular (LV) systolic dysfunction, and LV hypertrophy; other noncardiac issue(s) (e.g., drug use) were the sole reason in 20.6% of surveys citing only donor-specific issues. Donor age as a reason for offer refusal became increasingly prevalent over time, despite no accompanying change in the prevalence of older (50+ year-old) donors. Reasons for offer refusal varied widely by region, in a manner unexplained by regional differences in objective donor characteristics.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the subjective nature of donor heart assessment. Further scrutiny of non–evidence based reasons for refusal could reduce discard of viable donor hearts.</div></div>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 7","pages":"Pages 1075-1082"},"PeriodicalIF":6.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung transplant candidates' quadriceps strength is a modifiable predictor of recovery in exercise capacity after transplantation.","authors":"James R Walsh, Norman R Morris, Stephanie T Yerkovich, Matthew P Linnane, Daniel C Chambers, Peter M A Hopkins","doi":"10.1016/j.healun.2025.05.018","DOIUrl":"10.1016/j.healun.2025.05.018","url":null,"abstract":"<p><strong>Background: </strong>Defining a transplant candidate's suitable functional status and potential for rehabilitation is complex. Six-minute walk distance (6MWD) criteria are used in candidacy assessment, and pre-transplant quadriceps strength may be a predictor of rehabilitation potential. The study aims were to determine if candidates pre-transplant 6MWD and quadriceps strength are independent factors associated with post-transplant 6MWD and, compare the trajectory in 6MWD and quadriceps strength in candidates from initial assessment to waitlisting and from waitlisting to transplanted (or delisted/died).</p><p><strong>Methods: </strong>An observational repeated measures design was used. 6MWD and QS% were recorded at initial assessment, waitlisting, bi-monthly reassessments until transplanted/delisted/died and 2-, 6- 13- 26- and 52-weeks following transplantation.</p><p><strong>Results: </strong>342 (192 males; mean (±SD) age 51 ± 14 years; 119 COPD, 93 IIP, 72 cystic fibrosis, and 58 other) were studied. Recipients had a mean increase in 6MWD of 170 ± 127 m (p < 0.001) at 52-weeks post. Weekly 6MWD recovery was greater during the 2- and 6-week period (β 21.73, p < 0.001) compared to the 6- to 52-week period (β 1.28, p < 0.001). In the 2- to 6-weeks after transplantation, greater pre-transplant 6MWD (p < 0.001), stronger pre-transplant QS% (p = 0.001), shorter post-operative hospital admission (p < 0.001) and cystic fibrosis (vs other) were factors associated with a greater 6MWD. In the 6- to 52-weeks after transplantation, stronger QS% value at the corresponding time (p < 0.001), younger recipients (p < 0.001) and greater 2-week post-transplant 6MWD (p < 0.001) were factors associated with a greater 6MWD. Pre-transplant 6MWD decreased by -0.059 m (p < 0.001) and QS% increased by 0.014% (p < 0.001) per day between initial assessment to waitlisting (n = 287).</p><p><strong>Conclusions: </strong>Pre-transplant 6MWD and quadriceps strength are independent factors associated with recovery in exercise capacity after lung transplantation. However, candidates had a marked deterioration in 6MWD, but quadriceps strength had improved while being worked up for waitlisting. Quadriceps strength, along with 6MWD, should be considered when determining a candidate's lung transplant suitability.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and opportunities in donation after circulatory death heart transplantation.","authors":"Katherine G Phillips, Darren Stewart, Brian Wayda, Kelly Drozdowicz, Lena Trager, Alex Reyentovich, Marzia Leacche, Amit Alam, Nader Moazami","doi":"10.1016/j.healun.2025.05.019","DOIUrl":"10.1016/j.healun.2025.05.019","url":null,"abstract":"<p><strong>Background: </strong>Heart utilization from donation after circulatory death (DCD) donors remains highly variable across the United States, potentially resulting in missed transplantation opportunities. This study aimed to quantify the frequency of clinically viable, non-utilized DCD hearts and identify usage barriers.</p><p><strong>Methods: </strong>We conducted a retrospective, national registry analysis of donors ≤55 years old who donated ≥1 organ, focusing primarily on DCDs. Donor characteristics, particularly age, warm ischemic time (WIT), and ejection fraction (EF), as well as reasons for non-recovery and offer refusal, were analyzed. Scientific Registry of Transplant Recipients (SRTRs) heart yield model was employed to identify non-utilized DCD hearts clinically comparable to transplanted DCD hearts.</p><p><strong>Results: </strong>In 2023, 613 DCD hearts were transplanted, accounting for 13.5% of all heart transplants. Only 15.5% of DCD hearts from donors ≤55 years old were utilized. Marked variation in risk-adjusted DCD heart yield was observed between states, Organ Procurement Organizations (OPOs), and Regions. Donors of transplanted DCD hearts had a median age of 32, WIT 24 mins, and EF 63%. The yield model identified between 701 and 1,243 non-utilized DCD hearts with characteristics comparable to transplanted cases. Concerns about delayed progression to circulatory arrest after life support withdrawal was a key reason for non-utilization.</p><p><strong>Conclusions: </strong>Despite wider acceptance of DCD heart transplantation, an increasing proportion of DCD hearts remain unused despite favorable characteristics. Concerns related to delayed progression to circulatory arrest are a significant barrier to heart utilization. Addressing geographic variability and improving predictive models for donor viability could double DCD heart utilization and expand heart transplantation volume by approximately 700-1,200 (15%-27%) annually.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additional bidirectional Glenn anastomosis for managing right ventricular failure under left ventricular assist device circulation","authors":"Tomoki Ushijima MD, PhD ,&nbsp;Takeo Fujino MD, PhD ,&nbsp;Hiromichi Sonoda MD, PhD ,&nbsp;Yusuke Ando MD, PhD ,&nbsp;Akira Shiose MD, PhD","doi":"10.1016/j.healun.2025.02.1682","DOIUrl":"10.1016/j.healun.2025.02.1682","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":"44 7","pages":"Pages 1186-1188"},"PeriodicalIF":6.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thin blood and thinner margins in anticoagulation with left ventricular assist devices: Living on the Razor's Edge.","authors":"Ameesh Isath, Mandeep R Mehra","doi":"10.1016/j.healun.2025.05.016","DOIUrl":"10.1016/j.healun.2025.05.016","url":null,"abstract":"","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"200 Cases of Cardiac Donation after Circulatory Death Utilizing Normothermic Regional Perfusion: The Four-Year Vanderbilt Experience.","authors":"Aaron M Williams, Awab Ahmad, Swaroop Bommareddi, Brian Lima, Chetan Pasrija, Duc Nguyen, Mark Petrovic, Chen Chia Wang, Eric Quintana, Hasan K Siddiqi, Kaushik Amancherla, D Marshall Brinkley, JoAnn Lindenfeld, Jonathan Menachem, Henry Ooi, Dawn Pedrotty, Stacy Tsai, Lynn Punnoose, Aniket S Rali, Suzanne Sacks, Mark Wigger, Sandip Zalawadiya, Stephen A DeVries, Clifton D Keck, Shelley R Scholl, Anthony J Lepore, Matthew Warhoover, Kelly Schlendorf, Ashish S Shah, John M Trahanas","doi":"10.1016/j.healun.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.healun.2025.05.007","url":null,"abstract":"<p><strong>Objectives: </strong>Studies evaluating normothermic regional perfusion (NRP) for donation after circulatory death (DCD) heart recovery involve low volume centers or multi-center studies with wide variation in practice/technique. We sought to provide a single high-volume center's experience encompassing our program's evolution of NRP over time.</p><p><strong>Methods: </strong>Adult DCD heart transplant patients who received cardiac allografts recovered using only thoracoabdominal NRP were retrospective reviewed from October 2020 to November 2024. Donor and recipient pairs were divided into 4 groups (or Eras) based on year of transplant and compared. Hazard and confidence scores were compared highlighting changes in postoperative outcomes, and donor aggressiveness and high-risk recipients, respectively. NRP recovery details were compared.</p><p><strong>Results: </strong>Heart recovery attempts were made on 200 donors with 176 accepted for transplant (88%). Recipient postoperative outcomes demonstrated no significant difference across Eras. Functional warm ischemic time (FWIT) increased (p< 0.05) over the Eras. Cold ischemic time (CIT) also increased from Era 1 to Era 4 (p < 0.05). Allograft turn-downs due to technical reasons trended downwards from Era 1 (4/35, 11.5%) to Era 4 (1/62, 1.6%) (p = 0.16). The hazard score reflecting recipient outcomes was comparable across all four eras (p = 0.84), while the confidence score reflecting donor aggressiveness and high-risk recipients significantly increased (p < 0.05).</p><p><strong>Conclusions: </strong>Despite adopting a more aggressive approach with donor selection and high-risk recipients over time, technical improvements and evolution of the NRP recovery process has afforded continued excellent recipient outcomes that can be translatable to other centers.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of right ventricular reserve function during exercise on aortic valve opening in patients with left ventricular assist device.","authors":"Sakae Takenaka, Takuma Sato, Toshiyuki Nagai, Atsushi Tada, Yuta Kobayashi, Sho Kazui, Yutaro Yasui, Takeshi Hamaya, Yuki Mori, Akinori Takahashi, Suguru Ishizaka, Takao Konishi, Taro Temma, Kiwamu Kamiya, Tomonori Ooka, Satoru Wakasa, Toshihisa Anzai","doi":"10.1016/j.healun.2025.05.009","DOIUrl":"10.1016/j.healun.2025.05.009","url":null,"abstract":"<p><strong>Background: </strong>Although aortic valve (AV) opening during exercise has fewer adverse events in patients with a left ventricular (LV) assist device (LVAD), factors associated with it remain unclear. We hypothesized that right ventricular (RV) reserve function is associated with the AV opening status. This study aimed to explore the hemodynamic parameters observed at rest and during maximal exercise and investigate the association between the RV reserve function and AV opening status in patients with an LVAD.</p><p><strong>Methods: </strong>We prospectively examined 25 consecutive patients with an LVAD who underwent invasive exercise right heart catheterization with simultaneous echocardiography in the supine position. The AV opening status was assessed at rest and during exercise. The change in RV stroke work index (RVSWI) from rest to peak exercise (ΔRVSWI) was calculated to assess the RV reserve function. Patients were divided into three groups according to AV opening: AV opening both at rest and during exercise (n = 7), AV opening during exercise only (n = 8), and closed AV (n = 10).</p><p><strong>Results: </strong>Patients with a closed AV had significantly lower ΔRVSWI and ΔRV dP/dt max than those with AV opening both at rest and during exercise and AV opening during exercise only, whereas changes in pulmonary artery wedge pressure and pulmonary vascular resistance were comparable across the groups. In a multivariable logistic regression analysis, ΔRVSWI was independently associated with AV opening even after adjustment for the change in LV ejection fraction from rest to peak exercise. During a median follow-up period of 743 (interquartile range, 483-1037) days, the incidence of adverse events was higher in patients in the closed AV group than in those in the AV opening groups (p = 0.002).</p><p><strong>Conclusions: </strong>RV reserve function is associated with AV opening status in patients with an LVAD.</p><p><strong>Clinical trial registration: </strong>URL: https://www.umin.ac.jp/ctr/index.htm. Unique Identifier: UMIN000039001.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salidroside-loaded metal-organic frameworks hydrogel to improve cardiac allograft function.","authors":"Pengyu Zhou, Jianqiang Ji, Zhong Zhang, Xiu Liu, Xuan Pan, Chuanjie Niu, Jun Wan, Chaofan Wen, Ruiling Wang, Shaoyi Zheng, Shuai Liu, Honghao Hou, Jun Lu","doi":"10.1016/j.healun.2025.05.015","DOIUrl":"10.1016/j.healun.2025.05.015","url":null,"abstract":"<p><strong>Background: </strong>Ischemia-reperfusion injury (IRI) is a leading cause of primary graft dysfunction in heart transplantation. Metal-organic frameworks (MOFs) are widely applied as drug delivery carriers. Salidroside has been recognized for its potent anti-oxidative and anti-inflammatory effects. In this study, we developed the hydrogel incorporating salidroside-loaded MOF nanoparticles (Hydrogel/MOFSP) and applied it to the surface of post-transplant donor hearts to alleviate myocardial IRI.</p><p><strong>Methods: </strong>Hydrogel/MOFSP was synthesized to facilitate sustained and cardiac-targeted drug release for salidroside. We evaluated MOFSP nanoparticles or salidroside's anti-oxidative and anti-inflammatory properties in vitro. Furthermore, donor hearts were heterotopically transplanted after 3-hour cold storage with PBS (vehicle group), or salidroside or Hydrogel/MOFSP applied to the surface of donor hearts immediately after in vivo reperfusion. We investigated the cardiac function and the levels of oxidative stress, inflammation, and apoptosis of donor hearts after 6-hour heart transplantation and the mechanism of the cardioprotective effect of Hydrogel/MOFSP.</p><p><strong>Results: </strong>MOFSP nanoparticles or salidroside displayed anti-oxidative and anti-inflammatory properties in vitro, whereas applying Hydrogel/MOFSP rather than only salidroside to the surface of post-transplant grafts could improve cardiac function. Significantly reduced levels of myocardial oxidative stress, inflammation, and apoptosis were observed in the Hydrogel/MOFSP group. Hydrogel/MOFSP mitigated myocardial IRI for post-transplant grafts through the downregulation of P38/mitogen-activated protein kinase (MAPK) signaling pathway.</p><p><strong>Conclusions: </strong>Applying novel Hydrogel/MOFSP to the surface of post-transplant donor hearts improved graft function and alleviated myocardial IRI in heart transplantation. The cardioprotective effects of Hydrogel/MOFSP were achieved through the downregulation of the P38/MAPK signaling pathway.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy intravenous istaroxime up to 60 hours for patients with pre-cardiogenic shock.","authors":"Jan Biegus, Alexandre Mebazaa, Marco Metra, Matteo Pagnesi, Ovidiu Chioncel, Beth Davison, Christopher Edwards, Koji Takagi, Gerasimos Filippatos, Agnieszka Tycińska, Maria Novosadova, Gaurav Gulati, Marianela Barros, Maria Luz Diaz, Carlos Guardia, Robert Zymliński, Piotr Gajewski, Piotr Ponikowski, Phillip Simmons, Steven Simonson, Gad Cotter","doi":"10.1016/j.healun.2025.05.013","DOIUrl":"10.1016/j.healun.2025.05.013","url":null,"abstract":"<p><strong>Background and aims: </strong>A drug that improves blood pressure and cardiac output (CO) while reducing pulmonary wedge pressure safely is needed for patients with cardiogenic shock (CS) due to acute heart failure (AHF).</p><p><strong>Methods: </strong>In a randomized, double-blind, placebo-controlled trial, istaroxime 0.5 to 1.5 µg/kg/min for 24-60 hours was administered to 48 patients, and placebo to 42 patients, with pre-CS due to AHF under hemodynamic monitoring. Echocardiographic and Holter monitoring were done in both parts.</p><p><strong>Results: </strong>Patients randomized to istaroxime had a greater increase in systolic blood pressure (SBP) during the first 6 hours (primary endpoint), ls-mean (SE) 62.0 (6.59) mmHg*hour vs 36.4 (7.11) in the placebo arm (LS mean difference of 25.6 mmHg*hour, 95% CI 7.2-44.0 mmHg*h, P = 0.007). In patients administered istaroxime for at least 48 hours, SBP increase persisted for 60 hours. Istaroxime led to a greater increase in CO (0.66 L/min, P = 0.017) and decrease in wedge pressure (3.8 mmHg, P = 0.0017). Relative to average baselines of 3.6 L/min for CO and 22.5 mmHg for wedge pressure, this translates into improvements of 18.3% and 16.9%, respectively. Echocardiographic assessments showed improvements in E/A, TAPSE, and LA volume at 24 hours. There were improvements in eGFR at 24-72 hours and NYHA class to 72 hours. NT-proBNP increased more in istaroxime-treated patients. Heart rate decreased more in the first 24 hours in istaroxime-treated patients. No significant malignant arrhythmias were detected in patients treated with istaroxime on Holter monitoring.</p><p><strong>Conclusions: </strong>In this small study, istaroxime doses of up to 1.0 µg/kg/min for up to 60 hours were associated with improvements in SBP, CO and reductions in wedge pressure and heart rate without increases in arrhythmias.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers for human donor lung assessment during ex vivo lung perfusion.","authors":"Abby McCaig, Andrew Sage, Shaf Keshavjee, Mingyao Liu","doi":"10.1016/j.healun.2025.05.014","DOIUrl":"10.1016/j.healun.2025.05.014","url":null,"abstract":"<p><p>Lung transplantation remains the only curative treatment option for patients with end-stage lung disease, yet limited donor lung availability and utilization remains a significant obstacle. The ex vivo lung perfusion (EVLP) system allows for the extension of the donor assessment, providing the opportunity to perform advanced assessment on the isolated donor lung under near-physiological conditions. Measuring biomarkers in EVLP perfusate can provide valuable information on the condition of the donor lungs. This review examines biomarkers measured in EVLP perfusate and their ability to predict donor lung utilization and outcomes. Biomarkers in this review can be classified as cytokines, cell death, and endothelial-related molecules, showing potential for clinical application. Some of these biomarkers have also been used to monitor the effects of various therapeutics for donor lung repair or for modification of the EVLP technique. Yet, many limitations persist throughout these studies, which provides the opportunity for extensive future research. The integration of biomarkers with other data collected during EVLP through machine learning and artificial intelligence will lead to automated organ assessment to improve lung transplantation.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}