2. Immunomodulation at the peri-surgical step in lung transplantation

Lung transplantation is the only treatment for selected patients with chronic respiratory insufficiency. Graft survival rate at 5 years is 50% and mainly related to graft rejection and/or the secondary effects of immunosuppressive drugs. Lung transplantation management has improved recently due to the normothermic ex vivo lung perfusion which extends the number of suitable donor lungs and may reduce severe primary graft dysfunction, a risk factor of allograft failure. In the V2I team, we follow four lines of research all related to improving the peri-surgical management of lung transplantation, using the pig model and in human lungs:

1) improving the normothermic ex vivo lung perfusion through ventilation (negative versus positive pressure) and perfusion (purification, supplementation)

2) adapting the normothermic ex vivo lung perfusion to donor lungs from circulatory death

3) developing immunomodulatory gene transfer approaches using ex vivo lung perfusion for preconditioning

4) optimizing immunomodulatory treatments at the surgical step using cross-circulation, targeting macrophages

Collaborations: L. Jouneau (VIM-Jouy), C. Bevilacqua (GABI-Jouy), C. Richard & P. Chavatte (BREED-Jouy), M. Dalod and T. Vu Manh (CIML-Marseille)