Boffins keep transplant lungs alive in glass dome
'Reconditioned' organ bonanza foretold
Canadian medi-boffins have successfully trialled a method of keeping human lungs alive outside the body. They say that this will enable them to offer "reconditioned" lungs for transplant operations.
The idea is that often transplant docs have some lungs on hand, and people needing their present ones replaced, but the available lungs aren't in good enough nick to be used.
But now, with the Toronto XVIVO Lung Perfusion System, a set of lungs can be whipped out of the donor and put into a "protective, transparent bubble-like chamber". Here they are hooked up to a "pump, ventilator and filters through which flow oxygen, nutrients and a special solution" and kept at human body temperature.
According to Dr Shaf Keshavjee of Toronto General Hospital, "lungs can be safely kept on this circuit for 12 hours in order to assess, maintain and treat them before successfully transplanting them".
Keshavjee says that such "reconditioned" organs, given a careful tune-up in the XVIVO nutrient bubble-tank, could be a boon for lung-hungry Canada - where the queue for a transplant has doubled in the last ten years.
"This new technique heralds the beginning of a new era in transplantation," said Keshavjee's Toronto General colleague Marcelo Cypel.
"It has allowed us to progress from preserving donor lungs to actually being able to repair some of the injury before transplantation. And we have done this using a unique strategy on donor lungs outside the body."
The two docs were pleased to announce the first full trial of their kit. Andy Dykstra, 56, received a pair of reconditioned lungs earlier this month and is now back at home. The XVIVO system had been tested before, but Dykstra was the first patient to receive lungs "which could not have been used if they had not been repaired first".
"Many more donor lungs which we could not have used before can now potentially be used safely," said Keshavjee.
There's a vid of a lung being kept alive under glass here, for those who'd like to see it. ®
Why the increased need for lungs?
While not a key point to the story, does anyone know why the need for donor lungs has increased so sharply in Canada? Is this a general people- living- longer- means- more- things- will- break- before- they- depart- the- mortal- coil thing or is it related to something Canada- (or cities/ regions/ industries therein) specific?
I don't follow the "reconditioned" bit...
...but this is a major advance for lung transplantation. Kidneys are easy (for suitable values of 'easy') - whip 'em out, stick 'em in an ice bucket, transport, reimplant, bish bash bosh another punter off dialysis, but lungs are much more fragile. I was taught (though things may have improved) that lungs are generally moved directly from donor to recipient, only being out of the body for a very short time.
This techniques offers donors more time to get to a transplant centre, surgeons more time to assess the condition of the donor lungs BEFORE anaesthetising the recipient and opens the possibility of moving lungs around the country in the way we now do for kidneys.
But even I think it looked spooky...
If someone tries to patent this ...
... could Futurama be cited as 'prior art'? (we've got lungs in jars, so it can't be too big a step to heads in jars) :-)