Artificial lungs--Where are we going with the lung replacement therapy?

Justyna Swol*, Norihisa Shigemura, Shingo Ichiba, Ulrich Steinseifer, Masaki Anraku, Roberto Lorusso

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

4 Citations (Web of Science)

Abstract

Lung transplantation may be a final destination therapy in lung failure, but limited donor organ availability creates a need for alternative management, including artificial lung technology. This invited review discusses ongoing developments and future research pathways for respiratory assist devices and tissue engineering to treat advanced and refractory lung disease. An overview is also given on the aftermath of the coronavirus disease 2019 pandemic and lessons learned as the world comes out of this situation. The first order of business in the future of lung support is solving the problems with existing mechanical devices. Interestingly, challenges identified during the early days of development persist today. These challenges include device-related infection, bleeding, thrombosis, cost, and patient quality of life. The main approaches of the future directions are to repair, restore, replace, or regenerate the lungs. Engineering improvements to hollow fiber membrane gas exchangers are enabling longer term wearable systems and can be used to bridge lung failure patients to transplantation. Progress in the development of microchannel-based devices has provided the concept of biomimetic devices that may even enable intracorporeal implantation. Tissue engineering and cell-based technologies have provided the concept of bioartificial lungs with properties similar to the native organ. Recent progress in artificial lung technologies includes continued advances in both engineering and biology. The final goal is to achieve a truly implantable and durable artificial lung that is applicable to destination therapy.

Original languageEnglish
Pages (from-to)1135-1149
Number of pages15
JournalArtificial Organs
Volume44
Issue number11
DOIs
Publication statusPublished - Nov 2020

Keywords

  • artificial lung
  • biofabricated lung
  • end&#8208
  • stage lung disease
  • extracorporeal life support
  • extracorporeal membrane oxygenation
  • lung transplantation
  • wearable portable lung
  • EXTRACORPOREAL MEMBRANE-OXYGENATION
  • SINGLE-CENTER EXPERIENCE
  • IN-VITRO
  • GAS-EXCHANGE
  • LIFE-SUPPORT
  • PUMP-LUNG
  • FIBER BUNDLE
  • GOAT FETUSES
  • CO2 REMOVAL
  • BRIDGE

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