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D espite the high dem and, about 80% of donor lungs are rejected because they are not suitable for transplantation. Many lungs are considered unusable because of the injury that occurs with brain death and intensive care unit (ICU) complications, such as barotrauma, lung edema, aspirations, and pneumonia. This is what led to the development of ex-vivo lung perfusion. W ith all of the solid organs, typically they are retrieved, put on ice and transported to the transplanting facility. By putting lungs on ice, it prevents cell death. It slows down the dying process by stopping all cell metabolism from occurring and this m ethod has been widely accepted for preserving organ viability. But this strategy is non-selective, so vital enzymes and cell processes also stop working, which leads to cell edema and injury. By putting organs on ice, health care teams are essentially racing against time because the organ is dying and we are just slowing the dying process with the ice. The organ needs to get into a human body so it can be perfused. But ex-vivo lung perfusion is different because it allows lungs to be kept at normal body temperature, just like they would be in a human body. They can stay in this sterile bubble for hours and, in this time, we are able to see how the lung functions and if it can improve. So, with this technology, lungs that are questionable, lungs that normally would never be transplanted, such as those from cardiac death, can be taken and assessed for a few hours to see if they are any good instead of rejecting them right away. This technology also allows the re-expansion of areas that have collapsed, clearing of secretions, the sampling of blood gases, etc. Current research is looking at ways to heal lungs after aspiration, treating infections with high-dose antibiotics, using gene therapy to alter lungs, and regenerating gas exchange tis s u e - all prior to the lungs being transplanted into a recipient. [ABSTRACT FROM AUTHOR]