Aim: To build a mobile, extracorporeal membrane oxygenaEon (ECMO)-based ex vivo lung perfusion (EVLP) system and test two add-ons: conEnuous cytokine removal (CytoSorb®) and inhaled bronchodilators.

  • Model: 29 porcine lungs, perfused 24 h with cellular (whole-blood–based) perfusate and conEnuous ultrafiltraEon.

    • Groups: CytoSorb® (n=12) vs control (n=12); separate bronchodilator sub-study (n=5) vs solvent control (n=5).

  • Feasibility: Stable venElaEon/perfusion and metabolic/electrolyte balance maintained for 24 h.
  • CytoSorb® outcomes: Higher PaO₂/FiO₂, be_er dynamic compliance, less CT/histologic injury, lower lung weight gain (≈11.5% vs 42.2%), and reduced interleukin – IL-6/IL-8 vs controls (all p<0.05).
  • Bronchodilator outcomes: Lower peak airway pressure and higher compliance by 24 h (p<0.05).

Implication: Combining ultrafiltraEon with cytokine adsorpEon (and bronchodilaEon) enhances lung quality during prolonged EVLP which is promising for extended-criteria donors and longer preservaEon/logisEcs.