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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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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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.
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Long-term Outcomes of Lung Transplant With Ex Vivo Lung Perfusion
JAMA Surgery. 2019;154(12), pp.1143-1150
Divithotawela, C., Cypel, M., Martinu, T., Singer, L.G., Binnie, M., Chow, C.W., Chaparro, C., Waddell, T.K., de Perrot, M., Pierre, A. and Yasufuku, K.
Use of EVLP-treated lungs led to an increase in the number of patients undergoing transplantation, with comparable long-term outcomes.
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Outcomes after transplantation of lungs preserved for more than 12 h: a retrospective study
The Lancet Respiratory Medicine. 2017;5(2), pp.119-124
Yeung, J.C., Krueger, T., Yasufuku, K., de Perrot, M., Pierre, A.F., Waddell, T.K., Singer, L.G., Keshavjee, S. and Cypel, M.
Extension of clinical lung preservation times might allow for more transplantations to be done as a result of improved facilitation and increased flexibility around timing of lung transplantation operations.
- 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 ↩︎