MINI REVIEW article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
This article is part of the Research TopicEmerging Techniques in Graft Preservation: Machine Perfusion and Therapeutic Interventions - Volume IIView all 6 articles
Normothermic Regional Perfusion for Donation After Circulatory Death in Lung Transplantation
Provisionally accepted
- 1University of Kentucky, Lexington, United States
- 2The University of Texas Southwestern Medical Center Department of Surgery, Dallas, United States
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Donor supply of lung allografts lags behind the waitlist demand leading to an ongoing attempt to expand the donor pool. Recently this has mean increased utilization of donation after circulatory death (DCD). The concern about graft quality with this approach is more acute in fields with organs especially sensitive to ischemia, such as the lungs. One strategy being utilized to limit ischemic time is in situ thoracoabdominal normothermic regional perfusion with the use of extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (CPB) instituted after declaration of circulatory death to restore organ perfusion. This method is thought to decrease ischemic time, allow for correction of metabolic abnormalities, and provide longer for organ procurement. The data evaluating both the graft function and clinical outcomes following donation after circulatory death with normothermic regional perfusion (DCD-NRP) are growing with early results suggesting equivalent graft recovery and similar survival. This review aims to gather details of the procedure utilization, graft function, and patient outcomes and summarize the outcomes from a growing pool of data.
Keywords: Lung tranplant, Normothermic regional perfusion (NRP), Extracorporeal mebrane oxygenation, donation after circulatory death (DCD), Tranplant
Received: 01 Oct 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Gorton, Mohammadi, Malik and Keshavamurthy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Andrew J Gorton, andrew.gorton@uky.edu
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