Lung transplantation represents the only treatment for end-stage lung diseases. One of the significant challenges limiting the expansion of lung transplantation is the scarcity of available donor organs. In recent years, there has been a growing international focus on addressing this issue by exploring the maintenance and utilization of marginal lungs. One approach that has gained traction in Europe and the United States is Ex Vivo Lung Perfusion (EVLP), which involves perfusing and ventilating the lungs at normothermic conditions outside the body. This method offers several key advantages: it extends the preservation time of organs by simulating an in vivo environment, facilitating more thorough transplant preparation; it provides an objective assessment of donor lung quality, increasing the utilization of marginal donor lungs and reducing mortality among transplant recipients on the waiting list; it dilutes and filters microthrombi and inflammatory factors in the donor lungs and allows for drug treatment to improve and repair lung function, which is not achievable through traditional methods; and it enhances lung ventilation by re-expanding areas of collapsed lung tissue after perfusion and airway management. A wealth of clinical data supports the effective improvement of donor lung quality and the increased utilization of marginal donor lungs. Presently, our institution is the only one in China equipped with this EVLP system.

As the largest center for the diagnosis and treatment of pulmonary diseases in the country, in 2017, our hospital became the first in China to introduce and implement the EVLP system. We established ourselves as the only EVLP training center and clinical trial base in Asia. Furthermore, Vice Chief Physician Li Yuping visited the Cleveland Clinic in the United States to learn from the Cleveland Lung Transplant EVLP team and initiated clinical research and animal experiments on human donor lungs using EVLP, achieving positive results. Therefore, as the leading center in China with the most comprehensive range of lung transplant procedures and the best survival data, the introduction of this technology opens the door to the possibility of utilizing marginal donor lungs in a clinical setting. It has also trained a group of professionals for the maintenance of donor organs during the perioperative period of clinical lung transplantation. This effort will further increase the number of patients benefiting from lung transplantation, drive innovation in lung transplant techniques, and expand the utilization of marginal donor lungs.