# Using Advanced Imaging to Improve Ex Vivo Lung Perfusion

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $782,110

## Abstract

ABSTRACT / SUMMARY
While the number of lung transplantations performed worldwide is steadily growing every year, the number of
viable donor lungs remains frustratingly small compared to the increasing demand. Indeed, the vast majority of
potential donor lungs continue to be labeled as `marginal'—i.e., untransplantable—as a result of failing to meet
current clinical organ procurement criteria: harvested from a donor 55 years old or younger, clear on x-ray, and
adequately oxygenated under ventilation. However, because the measurements are based on an incomplete
assessment of donor lung tissue status, they may also be unnecessarily restrictive.
Developed as a technique for prolonging organ preservation prior to transplant while simultaneously offering a
platform for evaluating and potentially reconditioning `marginal' donor lungs, ex vivo lung perfusion (EVLP) was
first introduced in 2001 and has been employed clinically in hundreds of lung transplants since. To take full
advantage of EVLP as a tool for expanding the pool of transplantable donor lungs, however, the development of
non-invasive biomarkers capable of generating a more comprehensive assessment of donor lung health is
needed in order to optimize the utilization of `marginal' donor organs.
We propose to address this need by developing an imaging-compatible pre-clinical EVLP system capable of
obtaining structural, functional and metabolic biomarkers in the donor lung, that can be used to optimize EVLP
parameters in a rat lung transplant model. We will then utilize these biomarkers to non-invasively assess donor
lungs with three commonly occurring defects in donor lungs that have been shown to lead to poor post-transplant
outcomes: atelectasis, ventilator-induced lung injury (VILI), and reperfusion injury resulting from extended cold
ischemia. Injury-specific treatment strategies will be applied during EVLP in order to recondition lungs prior to
transplant, and surgical outcomes will be correlated post-transplant with imaging biomarkers obtained during
EVLP.
Finally, we will assess the full suite of developed markers to determine which justify translation, and will modify
a clinical EVLP system to demonstrate that the same biomarkers can be obtained in human lungs rejected for
transplant. Moving forward, the precise, quantitative, structural, functional, and metabolic information on donor
lungs that this platform provides can be used to non-invasively assess the protective effects of established
interventions aimed at rendering marginal lungs suitable for transplant—potentially unlocking EVLP's ability to
meaningfully increase the donor pool.

## Key facts

- **NIH application ID:** 10999701
- **Project number:** 1R01HL175937-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** EDWARD CANTU
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $782,110
- **Award type:** 1
- **Project period:** 2024-09-17 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10999701

## Citation

> US National Institutes of Health, RePORTER application 10999701, Using Advanced Imaging to Improve Ex Vivo Lung Perfusion (1R01HL175937-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10999701. Licensed CC0.

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