Human lungs rejected for transplantation can be recovered using cross-circulation with pigs

The reality of end-stage lung disease is that more patients have a greater need for lung transplants than available donors. The reason behind this is not only related to the small number of donors, but many donated lungs are severely damaged and unusable.

In some cases, the donated lungs are too damaging to be used for transplantation. But new experiments by researchers at Columbia Engineering and Vanderbilt University could solve this longstanding problem. The team used the living pig’s circulatory system to revive and repair damaged lungs by supporting circulation throughout the extracorporeal lung.

Human lungs that failed in EVLP (left) and then recovered in cross circulation (right).

Long port

Many people with severe lung disease may need a transplant to survive. The most common diseases that may urgently require patients for lung transplant are chronic obstructive pulmonary disease (COPD), cystic fibrosis, bronchiectasis, sarcoidosis, pulmonary hypertension, bronchoalveolar cancer. , Heart disease that affected the lungs, and lungs, among others, fibrosis.

Lung transplant is indicated for patients with end-stage lung disease who have tried to render all possible treatments useless. It is also recommended for patients with lung disease for whom no medical treatment is available.

According to the NHS, lung transplants are not routinely performed in the UK due to a lack of available donors. In fact, between 2017 and 2018, 214 lung transplants were performed in Japan.

In the United States, the most commonly transplanted organs are the kidney, liver, heart, lungs, pancreas, and intestine. There are about 75,000 people on the waiting list for organs, but only about 8,000 organ donors die each year. Organ donors donate at least 3.5 organs and living donors donate about 6,000 organs each year.

One of the problems physicians and patients face in the need for lung transplants is that the donated lungs are damaged and unusable. As soon as a person dies, the lungs begin to deteriorate. If the deceased is an organ donor, one of the most important things is to get the lungs to the recipient as soon as possible. The lungs are one of the most difficult organs to store because they are very fragile and delicate.

Another way

Lung disease is the third leading cause of death worldwide, and in most cases lung transplantation is the only cure for patients with end-stage lung disease. Despite advances in the medical field, lung transplants remain limited and the donated lungs suffer severe but potentially reversible damage.

Published in journal Natural medicine, Researchers led by Matthew Bachetta from Vanderbilt University and Goldana Bunjak Novakovic from Columbia University have found that they were damaged and too damaged to be transplanted into pigs, which could lead to animal kidney, liver, and other problems. The experiment was performed by connecting the lungs of 5 people who share the same function. New methods restore damaged lungs to function, providing ample time for recovery of severely damaged lungs that could not otherwise be preserved, and several hours of unique biological repair mechanisms ..

With the new technology, the temperature of the lungs is maintained and a bloodless solution containing oxygen, proteins and nutrients circulates in the lungs.

Video showing the sequence of lung recovery in a cross circulation system.

Investigation result

The team has been working on new technologies for the last eight years. They have developed a new method to provide lungs to patients who are in great need of organ transplants. In 2017, the team demonstrated the potential for circulatory support throughout the lungs outside the human body. Two years later, they demonstrated the effectiveness of cross-circulation by regenerating the lungs of severely damaged pigs. The team was also able to extend the cycle support cycle to an unprecedented four days.

The team also showed that lungs that had diminished due to transplantation could recover after 24 hours of circulation.

“We were able to recover donor lungs that could not be recovered with the current standard of care, the clinical ex vivo pulmonary perfusion system. This is the most rigorous validation of the circulatory circulation platform to date. Usefulness.”

The team believes their work is promising, but more research is needed before cross-circulation becomes a clinical reality. They hope that this technique can be used to rescue damaged lungs and help patients with end-stage lung disease get a second shot in life.