Mitochondria Research and Innovation Showcased at ISHLT 2026

What started off as a question about the importance of mitochondria in lung transplant has now led to groundbreaking innovation. Only 20% of donor lungs are accepted due to concerns about donor organ quality(1). A collaboration between Dr. Marcelo Cypel (Director, Toronto Lung Transplant Program, Ajmera Transplant Centre, Staff Thoracic Surgeon, University Health Network, Professor, Department of Surgery, University of Toronto, Co-Founder, Traferox Technologies Inc.) and Dr. Ana Andreazza (Scientific Director, MITO2i, Co-PI, MitoRevolution, Professor, Department of Pharmacology and Toxicology, Psychiatry, University of Toronto) began in 2021. At the time, MITO2i supported graduate students Aadil Ali (currently Director of Clinical Development, Traferox Technologies Inc.) and Erika Beroncal (currently Project Manager of MITO2i and MitoRevolution) in investigating the role of the temperature of lung storage on organ preservation and functional performance. Ultimately, this study demonstrated the importance of increasing the temperature of lung static storage from 4 degrees to 10 degrees Celsius (10C), leading to benefits to the grafts’ mitochondrial health and extending the length of time lungs are viable before implant. Recently, at the International Society for Heart and Lung Transplantation (ISHLT) 46th Annual Meeting here in Toronto on April 22 - 25, 2026, results of an international multicenter clinical trial comparing 10 degrees versus traditional storage were announced, confirming this benefit in the real world and supporting a shift in organ preservation practices worldwide.

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Traferox Technologies Inc., a company based in Toronto, co-founded by Dr. Cypel and Dr. Shaf Keshavjee (Co- founder, Traferox Technologies Inc. and Chief of Innovation, UHN), has since developed technology that preserves and transports lungs at 10C and an ex-vivo lung perfusion (EVLP) system that allows simplified normothermic assessment and treatment of donor lungs for improved decision making and increased organ utilization. From the combination of better preservation techniques with 10C and more accurate donor lung assessment with EVLP , the Toronto program not only doubled its number of transplants at the Toronto General Hospital, but also assisted in increasing the number of available, viable organs globally(2).

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The relationship between mitochondrial health and lung transplant outcomes is also a major driver of the current NFRF-T funded MitoRevolution project exploring the benefits of mitochondrial transplantation (MT). A number of members of the MitoRevolution project had the opportunity to attend ISHLT 2026 through travel grants provided by the Ajmera Transplant Centre. Dr. Gabriel Siebiger, MD and current PhD Candidate and MITO2i Innovation Scholar in Dr. Cypel’s Lab, is leading work to determine whether MT can be successfully achieved during lung preservation and EVLP with injured donor lungs, recovering otherwise non-transplantable organs. Additionally, Erika Beroncal, MSc and Project Manager for MitoRevolution, presented exciting work during ISHLT 2026 on mitochondrial haplogroup matching and its impact in lung transplantation outcomes. Finally, Dr. Cypel also gave a presentation at the conference about 10C Preservation: The Science and Mechanisms Behind Improved Preservation. It was a great opportunity for our trainees to network, learn about advancements in transplant research, and meet industry and community members. This

groundbreaking innovation in lung transplant highlights the importance of future interdisciplinary mitochondrial research in all aspects of health and disease.