Tomorrow's Cure – Episode Summary

Episode: "Inside EVLP: A Revolution for Donor Organs"

Podcast: Tomorrow's Cure (Mayo Clinic)
Release Date: March 11, 2026
Host: Kathy Werzer
Guests:

• Dr. Jack Haney – Cardiothoracic Surgeon, Mayo Clinic, Florida
• Brandy Zofke – Associate Vice President, Lung Bioengineering

Main Theme & Purpose

This episode explores the innovative technology of Ex Vivo Lung Perfusion (EVLP), a process that allows donor lungs to be evaluated and potentially reconditioned outside of the body. The discussion contextualizes the profound supply-demand challenges of lung transplantation, how EVLP is increasing the donor organ pool, and what this means for both patients and the future of transplantation.

Key Discussion Points & Insights

1. The Unique Challenge of Lung Transplantation

• Only about 13% of organ donors are able to donate lungs, a rate much lower than for livers, kidneys, or hearts (00:00).
• The shortage is due to the lungs' delicate nature and susceptibility to infection and injury (06:05).

“Lungs have probably the lowest recovery rate from available donors in 13 to 15% from a donor. That is far lower than liver, kidney or heart.”
— Dr. Haney [06:19]

The Patient Experience

• Being on the lung transplant waiting list is "incredibly stressful and scary," with patients suffering from severe shortness of breath and significant anxiety (01:38).
• This stress impacts caregivers, with some experiencing PTSD-like symptoms.

“To be short of breath… is an incredibly terrifying thing… a very powerless feeling when it comes to being short of breath. And that powerless feeling extends to their loved ones.”
— Dr. Haney [01:38]

Waiting Time & Organ Allocation

• Median wait time for lung transplant is about a month and a half, but can vary widely depending on severity and match (03:48).

2. The Concept and Significance of EVLP

What is EVLP?

• EVLP stands for "Ex Vivo Lung Perfusion"—lungs are maintained and evaluated outside of the donor body, allowing physicians to gather real-time functional data (00:23, 07:45).

“Every year, thousands of patients wait for a lifesaving lung transplant, but the need for donor lungs is greater than the supply... Ex vivo lung perfusion, or EVLP, is a groundbreaking procedure that evaluates lungs outside the body.”
— Kathy Werzer [00:23]

How the EVLP Process Works

• Donor lungs go to a dedicated EVLP center, where they are connected to a perfusion circuit and ventilator (09:28).
• The lungs are gradually warmed, ventilated, and perfused with solution. Their performance is assessed via blood gases, bronchoscopy, and imaging (09:28).

“Every hour after it goes on EVLP, we’re gathering data from the ventilator and from the blood gases… We do bronchoscopies… capturing X-ray images of the lungs…”
— Brandy Zofke [09:28]

Real-Time Communication & Decisions

• Lungs are monitored with real-time data sharing; transplant teams can observe remotely and make informed decisions (09:28).
• If deemed suitable, the lungs are cooled again and shipped back for transplantation.

3. Impact on Organ Eligibility and Program Practices

• EVLP allows transplant centers to consider and sometimes rehabilitate lungs that previously would have been rejected (13:41).
• Both guests note that EVLP introduces a "culture change,” raising acceptance rates and moving some marginal organs directly to transplant based on increased experience and confidence (20:46).

“Turning a no into a maybe and taking these lungs that maybe you wouldn't take direct to transplant, putting them on the device and then using that data to reevaluate whether or not you should use that organ.”
— Brandy Zofke [13:41]

• At Mayo Clinic, 40–50% of recent lung transplants have involved EVLP (20:05).

Revisiting Declines

• If a lung is not suitable for the primary recipient, centralized EVLP facilities facilitate reallocating to other centers, improving equity and efficiency (15:55, 28:47).

4. Outcomes and the Debate on Risk

• Studies and clinical experience show no significant difference in one-year outcomes between EVLP-processed and directly transplanted lungs (22:19).

“An organ coming off EVLP has the same short and intermediate term outcomes as a lung that was not on EVLP.”
— Dr. Haney [22:19]

• Dr. Haney asserts EVLP is now "conservative" rather than experimental—especially benefitting smaller or less-resourced centers by mitigating risk (30:59).

“I no longer think of EVLP lungs as an aggressive … experimental thing for big aggressive programs. I think of it as a fairly conservative thing.”
— Dr. Haney [30:59]

Expanding Access and Equity

• Centralized EVLP centers currently serve 25 transplant programs, including small and large centers—making organ access more equitable (29:36).

“That means that the smaller programs that would never have been able to invest in all of this equipment and expertise now can leverage a service provider to be able to do that.”
— Brandy Zofke [29:36]

5. The Future of EVLP & Transplant Medicine

• EVLP is not only a tool for evaluation but a potential platform for future therapies—such as gene or drug therapies that could further improve lung performance and immunologic compatibility (24:36, 26:47).

“Whether it’s xenotransplant and modifying pig organs … or 3D print a human lung … EVLP as a technology offers a lot of promise to say, hey, we can make better lungs to put into more patients.”
— Dr. Haney [25:38]

“This is something that we believe…ex vivo lung perfusion will be used for—to be able to be used as a platform for potential therapies like that.”
— Brandy Zofke [26:47]

• Both guests are excited about expanding the spectrum of usable lungs and about the ongoing improvement in storage, transport, and personalized matching (34:00).

Memorable Quotes & Moments

• “Being alive is the drive to breathe… when patients are on a wait list for lung transplant… they are incredibly anxious and incredibly stressed by that feeling.”
  — Dr. Haney [01:38]

• “You miss 100% of the shots you don’t take.”
  — Dr. Haney, referencing Michael Jordan (with a lively exchange with the host over hockey legend Wayne Gretzky) [16:53]

• “What we are doing today is actually just reevaluating a lung… turning a no into a maybe.”
  — Brandy Zofke [13:41]

• “Now the conversation is, it’s not a fire drill. This isn’t delivering a baby and have the suitcase ready by the door kind of thing … The patient stays at home until we better assess.”
  — Dr. Haney [35:27]

Timestamps for Key Sections

• 00:00–01:19 — Introduction & transplantation landscape
• 01:21–03:41 — Emotional impact of waiting for lungs
• 06:05–07:42 — Supply & recovery rate statistics
• 09:28–12:51 — How EVLP works, step-by-step
• 13:41–14:40 — Reconditioning and the limits of EVLP
• 16:29–17:14 — Deciding to decline an organ; balancing risk
• 20:05–21:17 — Adoption of EVLP, cultural changes in evaluation
• 22:05–25:38 — One-year outcomes and future directions
• 26:47–27:36 — Potential for gene therapy and true organ repair
• 28:47–30:49 — Equity, access for smaller centers
• 30:59–33:17 — EVLP becomes a standard tool, not just a backup
• 33:26–34:00 — Looking five to ten years ahead
• 35:27–36:27 — Evolving patient conversations due to EVLP

Final Takeaways

• EVLP is revolutionizing lung transplantation by making more lungs viable for transplant, thus saving more lives and improving access.
• The technology is becoming standard practice, democratizing access for programs of all sizes and raising the prospect for future, more advanced therapies.
• Patient and caregiver experiences are improving, with not just more lungs available, but also reduced uncertainty and stress due to the thoroughness of EVLP evaluation.
• Both guests anticipate a bright future for transplant medicine, with EVLP at the foundation of further innovations.

For anyone interested in the intersection of cutting-edge technology and real-world patient impact, this episode offers expert insight into a future that is rapidly becoming the present.