New Findings on Lung Preservation Temperature Could Extend Transplant Windows
Researchers at the University of Toronto report a notable shift in how donor lungs are stored before transplantation. In their latest work, lungs are kept at 10 degrees Celsius rather than the traditional near-freezing temperatures. This adjustment appears to extend the viable period for transplantation and could broaden the reach of available organs. The study highlights temperature management as a key factor in maintaining organ viability and influencing postoperative results. It contributes to growing evidence that preserving lungs at moderate warmth may affect both how organs are allocated and the survival prospects of patients awaiting transplants.
Historically, lung preservation has followed a cold-storage approach centered around four degrees Celsius with constant ice exposure. Under this method, lungs remain viable for roughly eight hours before procurement, transport, and implantation begin to carry a higher risk of complications. The most significant danger is primary graft dysfunction, a serious injury that can occur in the early days after transplant. PDT threatens many lung recipients and has historically limited how far donor lungs can travel, complicating matches and accelerating the transplant timeline.
The Toronto study introduces a different cooling strategy that raises the preservation temperature to 10 degrees Celsius. This shift seems to stabilize the organ over a longer window. Over approximately eighteen months, researchers tracked a cohort of 70 patients who received lungs preserved with the new method. Clinicians monitored a range of postoperative parameters, including how well oxygen exchange occurred, inflammatory markers, and early graft performance. Remarkably, none of the recipients developed primary graft dysfunction in the immediate postoperative period, a striking contrast to historical rates seen under conventional storage. While the result is preliminary and based on a single-center trial, it suggests that mild warmth during storage may reduce cellular stress and improve perfusion when the lung is rewarmed. The researchers stress that further multicenter trials are needed to confirm generalizability, quantify long-term benefits, and identify any trade-offs tied to the higher storage temperature.
From a logistical perspective, extending the preservation window has meaningful implications for transplantation practice. Longer storage times enable the transport of lungs over greater distances, supporting more flexible donor-recipient matching and reducing the time pressure that accompanies organ procurement. For patients on waiting lists, this could translate into more planned, elective surgeries rather than urgent, last-minute interventions. In turn, it may widen the donor pool and improve overall survival for those awaiting transplants. The study’s authors note that while better preservation can help address some organ shortages, it does not replace the need for broader donation campaigns, more careful recipient selection, or ongoing improvements in immunosuppression and postoperative care. A comprehensive strategy is needed to maximize patient outcomes and system-wide efficiency, particularly in health systems across North America where demand remains high and balancing supply with need is a continuous challenge.
Leaders in the transplant community have welcomed the findings with cautious optimism. They acknowledge the potential to redefine storage protocols and influence allocation decisions so patients receive timely, life-saving lungs. Critics point out that early results require replication in diverse clinical settings to ensure consistent performance. They also emphasize the importance of monitoring for any unintended consequences, such as changes in preservation-related injuries or shifts in postoperative care needs. Overall, the momentum from this work supports a broader move toward evidence-based optimization of every step in the transplant process, from donor evaluation and organ retrieval to long-term recipient monitoring and rehabilitation. The ongoing discussion among researchers, clinicians, and policymakers will shape how quickly such preservation strategies might become standard practice in the United States and Canada, and how they align with existing guidelines for organ allocation and utilization, including age and comorbidity considerations. In the meantime, the study adds a strong data point to the case for temperature-controlled, normothermic, or mildly hypothermic storage methods as part of a broader effort to improve transplant viability and patient survival.