Methods and practices to increase the donor pool in adult lung transplantation

As advancements in transplantation techniques continue, the challenge remains the limited availability of suitable donor organs. This chapter explores strategies to expand the donor pool and optimise transplant outcomes, which include the use of extended criteria donors, living lobar transplantation, donor-to-recipient graft size matching, and innovations in hypothermic storage and ex vivo lung perfusion (EVLP). Living lobar transplantation, which is prevalent in regions with low DBD rates, offers a life-saving alternative despite its inherent risks. Donor-to-recipient graft size matching is being refined through both traditional and innovative techniques. Hypothermic storage advancements, such as controlled temperature devices, aim to extend organ viability. EVLP preserves and rehabilitates marginal organs, offering new possibilities for gene and cell therapy. The integration of artificial intelligence in EVLP assessments further enhances precision in evaluating organ suitability, paving the way for safer and more effective transplant procedures. Standard measures related to clear donor detection pathways and optimisation of donor management also remain valid strategies to be improved.