ABSTRACT
I. Introduction Outcomes after lung transplantation have significantly improved over the last decade. Single-and bilateral-lung transplantations are now well-established treatment options for many end-stage respiratory diseases. The primary limitation to increased utilization of lung transplantation continues to be the availability of suitable allografts. After the initial limited clinical experience with lung transplantation in the early 1960s, performed with allografts from donors after cardiac death, the legal definition of brain death in the late 1960s promoted the shift to utilize organs from donors with maintained circulation and verified brain stem death (1). Furthermore, lungs from brain-dead donors may sustain diffuse damage secondary to catecholamine surge, endothelial activation, and inflammatory injury. Overall, lung utilization rates from donors after brain death remains about 20% worldwide, resulting in deaths on the waiting list, worsening clinical status of the patients waiting, and limiting wider application of lung transplantation to decrease the burden of lung disease.
