Lung transplantation after ex vivo lung perfusion versus static cold storage: An institutional cost analysis

Ex vivo lung perfusion (EVLP) is a novel lung preservation strategy that facilitates the use of marginal allografts; however, it is more expensive than static cold storage (SCS). To understand how preservation method might affect postoperative costs, we compared outcomes and index hospitalization costs among matched EVLP and SCS preserved lung transplant (LTx) recipients at a single, high‐volume institution. A total of 22 EVLP and 66 matched SCS LTx recipients were included; SCS grafts were further stratified as either standard‐criteria (SCD) or extended‐criteria donors (ECD). Median total preservation time was 857, 409, and 438 min for EVLP, SCD, and ECD lungs, respectively (p .99). These findings demonstrate that the use of EVLP was profitable at an institutional level; however, further investigation is needed to better understand the financial implications of EVLP in facilitating donor pool expansion in an era of broader lung sharing. Compared to static cold storage, use of ex‐vivo lung perfusion can be profitable at an institutional level and associated with similar post‐transplant outcomes, offering promising new evidence to support ongoing use of this novel, yet expensive technology to expand the donor pool.