Controlled perfusion of the transplanted lung

We read with interest the paper by Lick and associates reporting their experience of controlled reperfusion of the transplanted lung in humans [1]. It has been well documented in both small and large animals that limiting the initial perfusion pressure of lung grafts has a beneficial effect on function after reperfusion, which correlates with the amelioration of markers of injury such as oxygen free radical release and myeloperoxidase levels. This improvement can be further enhanced by the addition of leukocyte filtration and perfusion of the lung graft with neutrophil-depleted blood, as neutrophils are recognized as one of the most important injurious elements in the pathophysiologic cascade of events occurring at this time.