Could Donor Lungs Soon Be Assessed in 60 Seconds? New Technology Aims to Improve Organ Evaluation

By Brooke Wallace, BSN, RN, CCRN — founder of CPTCexam.com. ICU RN; previously worked as an Organ Procurement Coordinator and authored CPTC handbooks. CPTCexam.com is independent exam-prep and is not affiliated with or endorsed by ABTC.

NEWS

Researchers at the University of Waterloo, working with clinicians at University Health Network (UHN) / Toronto General Hospital, have developed MetaboSense—a modular microfluidic platform designed to continuously track glucose consumption and lactate production in donor lungs during ex vivo lung perfusion (EVLP). Primary coverage from Waterloo News (Sept 10, 2026) and a peer-reviewed paper in Advanced Science describe ~60-second temporal resolution for in-line metabolic monitoring—far denser than the hourly manual perfusate sampling common in clinical EVLP today.

Secondary press, including Transplant News, has framed the work as a faster path to organ assessment and a possible boost to lung transplants. That headline energy is understandable. The field-honest version is narrower and more useful: this is emerging EVLP analytics, not a new bedside ABG machine for hospital donor management, and it is not routine OPC practice. Researchers hope richer metabolic trajectories will help teams identify more lungs that can be safely used. That hope is not the same thing as a proven utilization lift.

Primary Waterloo release: uwaterloo.ca/news/.../new-monitoring-technology-could-help-identify-more-donor. Peer-reviewed paper (PMC): PMC13472114 · DOI 10.1002/advs.77123.

WHAT HAPPENED

EVLP—pioneered clinically out of UHN’s Toronto lung transplant program nearly two decades ago—lets teams ventilate and perfuse donated lungs outside the body, often for hours, to assess (and sometimes rehabilitate) organs that might otherwise be declined. During that window, teams already watch physiology and biochemistry: airway pressures, compliance, gases, pH, and metabolites in the perfusate. Glucose and lactate are among the most familiar metabolic readouts: lungs on EVLP consume glucose and produce lactate, and the pattern of those changes has been linked in prior work to function and decision-making.

The bottleneck MetaboSense targets is temporal. In standard clinical EVLP, glucose and lactate are typically sampled about once an hour, by hand, then run on a blood-gas analyzer. That is useful—and incomplete. Waterloo’s Dr. Mahla Poudineh (Canada Research Chair in Health Monitoring BioNano Devices) put it plainly: important metabolic changes can happen in the gaps between hourly samples. Following a lung’s metabolic trajectory continuously, rather than hourly, could give transplant teams more and better evidence for accept-or-decline decisions.

MetaboSense integrates a bead-based, quantum-dot–mediated aptamer assay with modular microfluidics (mixing, depletion, and optofluidic detection) for continuous, multiplexed, in-line glucose and lactate measurement. Device modules are roughly the size of microscope slides. In the Advanced Science paper, the platform showed analytical precision (R2 > 0.97), limits of detection in the clinically relevant millimolar range, and strong correlation with gold-standard ABG measurements across eleven clinical EVLP cases. In-line deployment on porcine EVLP circuits confirmed tracking of metabolite fluctuations at ~60-second scan resolution, including continuous monitoring during perfusion of a healthy porcine lung.

The project was supervised jointly by Poudineh and Dr. Andrew Sage, associate scientist at UHN’s Toronto General Hospital, with funding from the Canadian Institutes of Health Research (CIHR). Sage’s public framing matches the paper’s ambition without pretending the work is finished: continuous real-time measurements during EVLP can improve how teams collect function data and, ultimately, help identify more lungs that can be safely transplanted—if the technology matures into routine clinical use.

Early-stage reality check: This is validation science and engineering, not tomorrow-morning SOP. Secondary coverage has said the team is awaiting regulatory steps toward broader human clinical trial pathways. Whatever the exact regulatory timeline, MetaboSense is not something OPCs should expect on the donor-hospital cart next week. Treat it as emerging organ-assessment technology layered onto EVLP—not a replacement for donor management, imaging, bronchoscopy, or offer-time clinical judgment.

WHY IT MATTERS

Lung utilization is still one of the hardest stewardship problems in donation. Literature and press commonly cite that a large majority of lungs offered or considered—often framed around three-quarters to ~80%+ depending on the source—are never transplanted. Waterloo News pointed to UK NICE framing (“more than three-quarters”); the MetaboSense paper’s introduction cites literature around ~82% discard among lungs considered. Those figures are context for the clinical need, not proof that MetaboSense already moves the needle. Decline happens for many reasons: gas exchange, imaging, infection risk, anatomy, logistics, center appetite, and genuine uncertainty about how an organ will perform after reperfusion.

OPCs already live that uncertainty at the bedside. Current lung evaluation is a package: serial ABGs and P/F trends, chest imaging, bronchoscopy findings, vent strategy, secretions, hemodynamics, and the story of whether the lungs improved with management. (For the donor-management / DCU side of utilization, see our related piece: Can Better Donor Management Increase Lung Utilization?.) Acceptance often happens under incomplete information. Teams weigh donor-risk proxies—history, mechanism, time, cultures—against what the organ is actually doing right now.

EVLP was already a major shift from “donor risk score” thinking toward organ-function observation in a controlled environment. MetaboSense sits inside that shift. Instead of sparse metabolic snapshots, it aims for a continuous glucose/lactate trajectory—the kind of high-frequency signal critical care already values in other domains. The paper’s early high-frequency sampling vignettes (every 10 minutes in a small set of EVLP cases) illustrate why that matters: rejected lungs can show choppy metabolic patterns that hourly checks might blunt or miss, while a healthier trajectory can look steadier. That is hypothesis-generating clinical physiology, not a new acceptance algorithm glued to your offer sheet.

Machine perfusion context matters for OPCs who coordinate with transplant centers using EVLP or other ex vivo platforms. More temporal resolution during perfusion could, in theory, support better selection, earlier recognition of deterioration or recovery, and someday even closed-loop perfusion adjustments. Waterloo and UHN also note the modular design could eventually adapt to other ex vivo organs (liver, kidney, heart, pancreas) where glucose and lactate matter. All of that is future-facing. None of it licenses a claim that MetaboSense has already increased transplants.

Utilization caveat: Technology that improves assessment quality does not automatically raise transplant volume. Centers still decide. Logistics still constrain. Some lungs will remain non-transplantable for reasons metabolic sensors cannot fix. The honest upside is better decisions—including declining when the metabolic story is bad, and accepting when continuous data supports viability that hourly snapshots understated.

WHAT AN OPC SHOULD UNDERSTAND

If you are early in procurement, here is the field translation:

  • Know what MetaboSense is measuring. Glucose and lactate dynamics in EVLP perfusate—continuous / in-line—correlated with ABG in early validation. It is not a new hospital-bedside ABG substitute for donor management rounds.
  • Keep doing the lung work that gets organs to a decision point. Protective ventilation, secretion clearance, recruitment, hemodynamics, serial standardized P/F checks, imaging, and honest trend documentation still matter. Gadgets on EVLP do not replace optimization in the donor ICU or DCU.
  • Speak EVLP fluently when centers use it. Understand why teams send lungs to perfusion, what “assessment window” means, and that metabolic trends (glucose down / lactate up patterns, stability vs volatility) are part of how experienced programs think about graft quality—even when those labs are still intermittent.
  • Separate donor-risk proxies from organ-function data. History and risk flags start the conversation. Function—gases, imaging, bronch, and, on EVLP, metabolic trajectory—often finishes it. MetaboSense is another attempt to make organ function more visible in real time.
  • Do not oversell early tech on calls. Until platforms like this are validated for routine clinical in-line use and adopted by centers, your job is accurate communication: what is known on this donor today, what is trending, and what remains uncertain—not speculative device narratives.
  • Watch the pathway without waiting on it. Continuous EVLP analytics, cytokine sensing, and multi-organ perfusion monitoring are active research directions. OPCs who understand the trajectory will adapt faster when (if) tools graduate from papers to practice.

Bottom line: MetaboSense is a serious Waterloo–UHN collaboration aimed at turning hourly metabolic snapshots during EVLP into near-continuous organ-function data. That is scientifically exciting and clinically relevant to the utilization problem. It is also early. For now, the highest-leverage OPC skill remains the same—manage the donor lungs in front of you carefully, package the assessment honestly, and leave room for function-based decisions when centers take lungs to EVLP.

If you are a new OPC building confidence in lung evaluation and donor management—or studying for the CPTC exam—CPTCexam.com has free and structured prep materials, including CPTC exam study resources and the OPO New Coordinator to CPTC-Ready Curriculum ($200). Use what helps you manage the next donor better.

Field-honest donor management and organ-assessment education from someone who has done the work—CPTCexam.com.

Sources

  1. University of Waterloo. New monitoring technology could help identify more donor lungs for transplantation. Sept 10, 2026. https://uwaterloo.ca/news/news/new-monitoring-technology-could-help-identify-more-donor
  2. Srikant S, et al. MetaboSense: An Integrated Quantum Dot-Mediated Aptamer Assay and Modular Microfluidic Platform for Continuous In-Line Monitoring of Lung Metabolism During Ex Vivo Perfusion. Advanced Science. 2026. doi: 10.1002/advs.77123. PMC: PMC13472114
  3. Transplant News. CANADA: University Of Waterloo Device Could Speed Organ Assessment, Boost Donor Lung Transplants. Sept 18, 2026. https://transplantnews.com/organ_tissue/canada-university-of-waterloo-device-could-speed-organ-assessment-boost-donor-lung-transplants/ (secondary coverage; EVLP framing per Waterloo/UHN primary sources)
  4. Related CPTCexam.com: Donor lung management, DCU, and lung utilization
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