Preservation and Transport at 10°C is a Game Changer
Clinical and preclinical research has shown promising outcomes with organs preserved at 10°C.
Optimized preservation. Extended duration.
- Extended Preservation Demonstrated in Multi-Centre Study
A multi-centre study showed that preservation time could be extended to twice the typical time with no increase in complications1 - Improved Mitochondrial Health with 10°C Preservation
Lungs preserved at 10°C have better mitochondrial health and preserved donor organ function2
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The studies below may not have used the commercial version of X°Port. Please review the materials and methods of individual studies for details.
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Extended Donor Lung Preservation Beyond 24 Hours Yields Acceptable Outcomes Using 10°C Static Preservation: First Clinical Experience from Two High Volume North American Centers
ISHLT 2026 Annual Meeting & Scientific Sessions. Presentation.
J. Montagne, M. Cerullo, Y. Suzuki, C. Demarest, G. Garza, J. Yeung, et al.
Prolonged cold static preservation of donor lungs at 10 °C beyond 24h appears safe and does not adversely affect short- to intermediate-term outcomes
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Clinical Impact of Duration of Second Cold Ischemic Time at 10°C After Ex Vivo Lung Perfusion
ISHLT 2026 Annual Meeting & Scientific Sessions. Poster.
J. Montagne, A. Wang, A. Mariscal, G. Loesch Siebiger, G. Garza, P. Oliveira, et al.
This data supports the safe extension of CIT2 at 10°C after EVLP, providing logistical flexibility and expanding opportunities for successful lung transplantation.
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Post-Reperfusion Metabolic Implications of 10°C Static Preservation of Donor Lungs
ISHLT 2026 Annual Meeting & Scientific Sessions. Featured Poster.
M. Martinez Santos, A. Wang, A. Ali, M. Liu, S. Keshavjee, M. Cypel.
Extended 10°C preservation primes lungs for superior metabolic recovery and allograft resilience during EVLP, likely contributing to reduced ischemia reperfusion injury and improved outcomes.
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Enhancement of Organ Preservation Solution with Lipid-Based Energy Substrates Optimize 10°C Donor Lung Preservation
ISHLT 2026 Annual Meeting & Scientific Sessions. Poster.
P. Melo, J. Yune, Y. Zhang, G. Loesch Siebiger, G. Garza, M. Bosone, et al.
Lipid supplementation of LPD enabled cellular processes to improve graft quality during hypothermic preservation at 10°C.
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Extension of Cold Static Donor Lung Preservation at 10°C
New England Journal of Medicine Evidence. 2023;2(6)
Ali, A., Hoetzenecker, K., Campo-Cañaveral de la Cruz, J., Schwarz, S., Barturen, M.G., Tomlinson, G., Yeung, J., Donahoe, L., Yasufuku, K., Pierre, A. and de Perrot, M.
Lung preservation at 10°C allows for longer preservation times and is safe and effective, with no significant differences from lungs stored for half the time.
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Prolonged Preservation of up to 24h at 10°C does not impact outcomes after lung transplantation
Annals of Surgery. 2025;281(4), pp.664-670
Hoetzenecker, K., Ali, A., Campo-Cañaveral de la Cruz, J., Schwarz, S., Crowley Carrasco, S., Romero Roman, A., Aladaileh, M., Benazzo, A., Jaksch, P., Wakeam, E., Aversa, M., Keshavjee, S., Cypel, M.
Prolonged static preservation of donor lungs at 10°C for up to 24 hours is safe and does not impair short-intermediate outcomes after lung transplantation.
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Static Lung Storage at 10°C Maintains Mitochondrial Health and Preserves Donor Organ Function
Science Translational Medicine. 2021;13(611)
Ali, A., Wang, A., Ribeiro, R.V., Beroncal, E.L., Baciu, C., Galasso, M., Gomes, B., Mariscal, A., Hough, O., Brambate, E. and Abdelnour-Berchtold, E.
10°C lung preservation results in better mitochondrial health compared to 4°C controls, resulting in better lung function.
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Evaluation of 10°C as the optimal storage temperature for aspiration-injured donor lungs in a large animal transplant model
The Journal of Heart and Lung Transplantation. 2022;41(12), pp.1679-1688
Abdelnour-Berchtold, E., Ali, A., Baciu, C., Beroncal, E.L., Wang, A., Hough, O., Kawashima, M., Chen, M., Zhang, Y., Liu, M. and Waddell, T.
10°C demonstrated as a potentially superior storage temperature for injured donor lungs in a pig model when compared to the current clinical standard (4°C) and immediate transplantation.
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Overcoming the limits of lung transplantation: 10°C static cold preservation
Archivos de Bronconeumologia. 2023;59(5), pp.282-283
Campo-Cañaveral de la Cruz, J., Barturen, M.G., Ali, A., Hoetzenecker, K. and Cypel, M.
Donor lung preservation methods are moving forward at a continuous and exciting pace, which will significantly change the entire field of lung transplantation
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Donor Lung Preservation at 10°C: Clinical and Logistical Impact
Archivos de Bronconeumología. 2024;60(6), pp.336-343.
Barturen, M.G., Hernández, R.L., Berrocal, A.R., Redondo, M.P., Lozano, N.G., López, J.M., Vicente, A.R., Román, A.R., Mejía, L.H., Carrasco, S.C., Gómez de Antonio, D., Naranjo Gómez, J.M., Córdoba Peláez, M., Novoa, N.M., Campo-Cañaveral de la Cruz, J.L
Preservation at 10°C may represent a safe and feasible strategy to intentionally prolong the CIT. Extending the CIT at 10°C may allow for semi-elective LTx and improve logistics with similar outcomes compared to the current standard preservation methods.
EVLP Enables Optimization of Available Donor Organs
Increased transplant volume. Decreased mortality.
- Significantly expanded donor lung availability1
Studies have shown increases in the number of lung transplants when EVLP is used for donor lung assessment, with comparable outcomes to patients who received lungs that did not require assessment via EVLP. - Increased transplant volume drives efficiency and outcomes2
Higher transplant rates have been linked to reduced waitlist times, shorter ICU stays, and improved long-term patient outcomes—resulting in meaningful cost savings.
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Predicting Post-Transplant FEV1 Using Donor Lung Function Measured During EVLP with Machine Learning
ISHLT 2026 Annual Meeting & Scientific Sessions. Presentation.
D. Piyasena, S. Hacker, H. Ahmed, X. Zhou, M. Wei, N. Sawal, M. Cypel, A. Sidhu, T. Martinu, S. Keshavjee, A. Sage.
Machine learning models leveraging donor lung function measured during EVLP can accurately forecast post-transplant FEV1 with the best reported performance to date.
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A Machine Learning Algorithm to Quantify the Impact of Smoking in Donor Lungs Assessed on Ex Vivo Lung Perfusion
ISHLT 2026 Annual Meeting & Scientific Sessions. Presentation.
L. Ronen, S. Hacker, T. Borrillo, D. Rozenberg, L. Del Sorbo, M. Cypel, S. Keshavjee, A. Sage.
A machine learning algorithm, termed the ‘Smoking Impact Index’ (SII) provides a quantitative metric that can assist in selecting donor lungs for transplant. The SII achieved an accuracy of 92.5%.
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Using Artificial Intelligence and Machine Learning to Improve Selection of Donor Lungs for Ex Vivo Lung Perfusion
ISHLT 2026 Annual Meeting & Scientific Sessions. Poster.
H. Ahmed, D. Piyasena, T. Waddell, M. Cypel, S. Keshavjee, A. Sage
This ML tool shows strong potential to support early triage by identifying donor lungs that are strong candidates for EVLP reconditioning. The EVLP candidacy model achieved an AUC of 77 ± 3%.
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Towards Digital Twins of Ex Vivo Human Lungs for Restrictive and Obstructive Lung Diseases Using Machine Learning
ISHLT 2026 Annual Meeting & Scientific Sessions. Presentation.
S. Hacker, L. Del Sorbo, X. Zhou, Y. Wei, T. Borrillo, M. Cypel, B. Wang, S. Keshavjee, A. Sage.
EVLP-based digital twins effectively capture trends in key respiratory parameters of lungs with disease-like phenotypes.
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Safe and Efficient Endothelial Gene Transfection Using Lipid Nanoparticles During Ex Vivo Lung Perfusion
ISHLT 2026 Annual Meeting & Scientific Sessions. Presentation.
J. Yune, P. Melo, G. Loesch Siebiger, Y. Zhang, A. Nagoya, A. Strilchuk, X. Yue, X. Fu, S. Juvet, M. Liu, L. Bowen, S. Keshavjee, M. Cypel, A. Wang
These results demonstrate safe and effective LNP-based delivery of genetic payload to donor lungs during EVLP.
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Membraneless EVLP Maintains Stable Lung Function in a Gastric Juice Injured Pig Model
ISHLT 2026 Annual Meeting & Scientific Sessions. Presentation.
G. Garza, A. Wang, J. Yune, J. Montagne, N. Furie, P. Melo, Y. Zhang, G. Loesch Siebiger, F. O. Gao, L. Del Sorbo, M. Liu, S. Keshavjee, M. Cypel
In a porcine model (n=5/group) of aspiration-injured donor lungs, cellular membraneless EVLP maintained stable function over 12 hours and showed lower lactate and cytokine levels
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1,000 Cases of Ex Vivo Lung Perfusion for Lung Transplantation: A Single Centre Experience
The Journal of Thoracic and Cardiovascular Surgery. 2025.
Keshavjee, S., Sage, A.T., Borrillo, T.., Yeung, J.C., Piyasena, D., Wakeam, E., Donahoe, L., Waddell, T.K., de Perrot, M., Pierre, A., Balachandran, S., Ghany, R., Ali, A., Yasufuku, K., Cypel, M.
This study presents the largest single-centre EVLP experience to date, highlighting how EVLP has transformed clinical lung transplantation with expansion of donor access, program growth, and the safe use of extended criteria donor lungs.
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Normothermic ex vivo lung perfusion in clinical lung transplantation
New England Journal of Medicine. 2011;364(15), 1431-1440
Cypel, M., Yeung, J., Liu, M., Anraku, M., Chen, F., Karolak, W., Sato, M., Laratta, J., Azad, S., Madonik, M., Chow, C., Chaparro, C., Hutcheon, M., Singer, L., Slutsky, A., Yasufuku, K., de Perrot, M., Pierre, A., Waddell, T., Keshavjee, S.
Transplantation of high-risk donor lungs that were physiologically stable during 4 hours of ex vivo perfusion led to results similar to those obtained with conventionally selected lungs.
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Evaluating the impact of ex vivo lung perfusion on organ transplantation: a retrospective cohort study
Annals of Surgery. 2023;278(2), pp.288-296
Peel, J.K., Pullenayegum, E.M., Naimark, D., Aversa, M., Liu, M., Del Sorbo, L., Barrett, K., Sander, B. and Keshavjee, S.
A significant increase in organ transplantation was observed since EVLP was introduced into practice, predominantly from increased acceptance of donation after circulatory death and extended-criteria lungs.
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Determining the impact of ex-vivo lung perfusion on hospital costs for lung transplantation: A retrospective cohort study
The Journal of Heart and Lung Transplantation. 2023;42(3), pp.356-367
Peel, J.K., Keshavjee, S., Naimark, D., Liu, M., Del Sorbo, L., Cypel, M., Barrett, K., Pullenayegum, E.M. and Sander, B.
EVLP availability was associated with faster progression to transplantation at no significant marginal cost in this single-center study.
- Ali, A., Hoetzenecker, K., Luis Campo-Cañaveral de la Cruz, J., Schwarz, S., Barturen, M.G., Tomlinson, G., Yeung, J., Donahoe, L., Yasufuku, K., Pierre, A., de Perrot, M., Waddell, T.K., Keshavjee, S., Cypel, M.. Extension of Cold Static Donor Lung Preservation at 10°C. NEJM Evid. 2023 Jun;2(6):EVIDoa2300008. doi: 10.1056/EVIDoa2300008. Epub 2023 Apr 20. PMID: 38320127. ↩︎
- Ali, A., Wang, A., Ribeiro, R.V.P., Beroncal, E.L., Baciu, C., Galasso, M., Gomes, B., Mariscal, A., Hough, O., Brambate, E., Abdelnour-Berchtold, E., Michaelsen, V., Zhang, Y., Gazzalle, A., Fan, E., Brochard, L., Yeung, J., Waddell, T., Liu, M., Andreazza, A.C., Keshavjee, S., Cypel, M. Static lung storage at 10°C maintains mitochondrial health and preserves donor organ function. Sci Transl Med. 2021 Sep 15;13(611):eabf7601. doi: 10.1126/scitranslmed.abf7601. Epub 2021 Sep 15. PMID: 34524862 ↩︎