title: Contemporary review of the organ care system in lung transplantation: potential advantages of a portable ex-vivo lung perfusion system.
abstract: Lung transplantation remains the definite treatment for various end-stage lung diseases. Cold flush perfusion, the standard method for organ procurement has severe limitations. Organ Care System (OCS; TransMedics, Inc., Andover, USA) is an approved method to preserve hearts for transplantation that allows for greatly reduced cold ischemic time. Consequently, the use of an adapted OCS lung as a portable full ex-vivo lung perfusion system in lung transplantation is currently under close evaluation. Areas covered: The aim of this article is to review the advantages and the role of the OCS in the field of lung transplantation by reviewing the latest literature and evaluating this novel procurement technique in the context of conventional methods like cold flush and regular ex-vivo lung perfusion. Expert commentary: The use of OCS in the field of lung transplantation has great potential for improved patients outcomes and is justified in cases with (i) marginal donor lungs, (ii) foreseeable long time of transportation (iii) high-risk recipient or donor /recipient profiles, particularly in the setting of an overall increasing need for suitable donor organs. Results from two major multi-centre prospective studies are pending to objectively assess the possible advantages of this portable ex-vivo lung perfusion system.
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.|b University Hospital Heidelberg, Heart Centre Heidelberg, Clinic for Cardiac Surgery , University of Heidelberg , Heidelberg , Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Schmack
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Alexander
authors.initials: A
authors.lastname: Weymann
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Prashant
authors.initials: P
authors.lastname: Mohite
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Garcia Saez
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Bartlomiej
authors.initials: B
authors.lastname: Zych
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.|c Department of Cardiothoracic Surgery , Heart Centre of the University of Cologne , Cologne , Germany.
authors.forename: Anton
authors.initials: A
authors.lastname: Sabashnikov
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.|c Department of Cardiothoracic Surgery , Heart Centre of the University of Cologne , Cologne , Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Zeriouh
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Joel
authors.initials: J
authors.lastname: Schamroth
authors.affiliation: d Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Centre Essen , University Hospital Essen , Essen , Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Koch
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Simona
authors.initials: S
authors.lastname: Soresi
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Olga
authors.initials: O
authors.lastname: Ananiadou
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Fabio
authors.initials: F
authors.lastname: De Robertis
authors.affiliation: b University Hospital Heidelberg, Heart Centre Heidelberg, Clinic for Cardiac Surgery , University of Heidelberg , Heidelberg , Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Andre Ruediger
authors.initials: AR
authors.lastname: Simon
authors.affiliation: a Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust , Harefield Hospital , Harefield , UK.
authors.forename: Aron Frederik
authors.initials: AF
authors.lastname: Popov
mesh_terms: D000818:Animals; D006801:Humans; D008168:Lung / Q000098:blood supply*; D016040:Lung Transplantation; D010477:Perfusion / Q000379:methods*
keywords: Lung transplantation; ex-vivo lung perfusion; ischemic time; organ care system; organ transplantation; primary graft failure