University of Texas Southwestern (UTSW) Medical Center surgeons have successfully performed the state’s first lung transplant using a new technology, in which physicians treated the donated lungs with ex-vivo lung perfusion (EVLP).
EVLP helps doctors to assess and re-condition donor lungs that might not otherwise have been usable. The system runs artificial blood through the circulatory system, increasing how long a donor lung can be evaluated and how long it remains healthy before it is placed in the recipient. Before the availability of this technology, healthcare providers had to race against time to get lungs from donors to transplant recipients.
“Currently, more than 70 percent of potential donor lungs are deemed unusable,” Dr. Fernando Torres, a professor of Internal Medicine and medical director of the Lung Transplantation Program at UTSW, said in a news release. “EVLP technology is an assessment tool that will allow us to evaluate organs that are marginal over an extended period of time. We can see how well these lungs inflate and deflate, see how well gas exchange is happening, and some of these lungs will be found to be suitable for transplant.”
UTSW is one of 16 medical centers in the U.S. — and the only one in Texas — participating in a national clinical trial of the technology using a device known as XVIVO. If successful, the trial could significantly increase the number of donor lungs available for transplantation.
“Some of the lungs we see are clearly not usable because of infections, bad contusions, and so on, but with others, it’s simply not clear,” said Dr. Pietro Bajona, assistant professor of Cardiovascular and Thoracic Surgery and director of the EVLP Program. “We can put the questionable lungs in the machine, ventilate them, perfuse them with a special solution, and then after a few hours test them.
“There are many people who are waiting for a transplant who are very sick, and even though the number of donors is increasing, there are still not enough lungs available to meet demand,” Dr. Bajona added.
EVLP is expected to increase the number of lungs available for transplant by 10 percent to 15 percent.
The XVIVO device, created by a Swedish company, has already been approved for use in Europe and Canada, and the trial will help determine whether it might be approved for general use in the U.S.
“Ex-vivo perfusion technology allows us to evaluate organs for transplantation that we either would not previously have considered for transplantation or would have declined in the operating room. If the ex-vivo evaluation is favorable, we can then implant the perfused lungs,” said Dr. Matthius Peltz, who led the surgical team that performed the transplant.
In 2015, more than 200 people died in the U.S. waiting for a lung transplant.