ABSTRACT Tens of thousands of Americans with end stage lung disease (ESLD) are not candidates for lung transplant and thus are doomed to suffer a long and miserable death from dyspnea, limitation of activity, and eventually total respiratory failure. The long-term goal of this technology-development project is to improve the quality of life of end stage lung disease (ELSD) patients by developing wearable artificial lungs that compensate for the changing metabolic needs of the patient. The objectives of the current proposal are to: 1) develop the smart, wearable artificial lung system; and, 2) evaluate the wearable artificial lung system in acute and chronic animal models. At the completion of this project, we will have a functioning wearable artificial lung system that adjusts CO2 clearance based on patient needs, thereby enabling large changes in patient activity and disease status during rehabilitation and daily life. We will be ready to perform extended animal tests and apply for an IDE for first in human trials.