Bioengineered platforms for recovery and regeneration of the lung

Lung disease is the third leading cause of death worldwide. The shortage of transplantable donor organs has profound consequences, especially for patients with end-stage lung disease, where transplantation remains the only definitive treatment. Donor organ demand far exceeds supply; and currently four out of five donor lungs are deemed unacceptable for transplantation at the time of donation, making lung the least utilized solid organ. To address the donor organ shortage, the recovery of lungs unacceptable for transplantation and the development of lung substitutes or biologic constructs capable of long-term gas exchange are under investigation. However, significant challenges remain due to a limited understanding of lung development, stem cell biology, and the mechanisms of lung injury and repair. Accordingly, novel biomaterials capable of elucidating underlying mechanisms of lung regeneration as well as facilitating strategies in lung tissue engineering, regenerative medicine, and therapeutic cell delivery would have great utility. Furthermore, robust biosystems capable of prolonged whole organ support would enable extended organ recovery times, advanced therapeutic interventions, and recipient-specific organ manipulation. The integration of new mechanistic insights into lung regeneration, novel biomaterial therapeutics, and a platform for prolonged extracorporeal organ support will enable the functional recovery and use of donor lungs initially unacceptable for transplantation. Herein is described the development and validation of (i) tissue-specific extracellular matrix biomaterials as biomedical research tools, (ii) ex vivo lung perfusion systems in small and large animal models, and (iii) a clinical-scale organ support and recovery system with novel strategies for the delivery of pulmonary therapeutics.