Thursday, December 15, 2011

First ‘ex-vivo’ Lung Transplants Performed in New York

In Canada, Dr. Shaf Keshavjee and his team implemented investigational trials of the Toronto ex-VIVO Lung Perfusion System which has been highly successful in saving the lives of many patients who would normally not have received their donor lungs because they were unsuitable for transplant. Only about 15% of donor lungs world-wide are acceptable for transplantation since lungs are susceptible to injuries during the brain-death process or from intensive care related lung complications. Moreover, organ retrieval often occurs before the lungs can recover from their injuries. View a video presentation of the EX-vivo system by Dr. Keshavjee at TEDMED 2010

Recipients of first transplanted lungs assessed and reconditioned in the operating room, a technique with the potential to dramatically boost the availability of lungs for transplant were two elderly New Yorkers. The experimental procedure was performed by Dr. Frank D'Ovidio at NewYork-Presbyterian Hospital/Columbia University Medical Center.

The "ex vivo" or outside-the-body approach involved removing lungs from a deceased donor, then enclosing them inside a transparent dome and connecting them to a cardiopulmonary pump and a ventilator. For four hours, the lungs were infused with nutrients and antibiotics. They were gradually warmed to body temperature, ventilated and oxygenated -- a process that resembles breathing, with the lungs inflating and deflating. Once determined to be viable, the lungs were immediately transplanted into the patients.

"Assessing lungs this way gives us a much more precise picture of how they should perform after transplant, and the reconditioning process may actually improve the chances of success," says Dr. D'Ovidio, associate surgical director of the lung transplant program at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of surgery at Columbia University College of Physicians and Surgeons.

Traditionally, transplant surgeons have relied on a less sophisticated assessment. "Now with the ex vivo method, not only can we see the lungs inflate and deflate, but we also get hard data on how they function by monitoring multiple parameters and ultimately making sure that the gas exchange is happening at the level it needs to," continues Dr. D'Ovidio.

Going forward, the ex vivo procedure could significantly increase the availability of donor lungs, says Dr. D'Ovidio. "This has the potential to do for lung transplant what perfusion has done for kidney transplant. With the tool to better assess, recondition and possibly repair the organs, we can increase the number available to patients who desperately need them."

Currently, fewer than 30 percent of donor lungs are acceptable for transplantation, but physicians say ex vivo has the potential to double this figure as the reconditioning process is refined and improved.

The recent transplants at NewYork-Presbyterian/Columbia are part of an ongoing FDA investigational multicenter clinical research trial designed to compare outcomes from lung transplants using the ex vivo technique with those using the traditional method. This investigational trial, currently taking place in the United States, is coordinated and funded by Vitrolife, makers of the ex vivo perfusion system.

“You Have the Power to Donate Life – to become an organ and tissue donor Sign-up today!
Tell Your Loved Ones of Your Decision”
Australia, register at Australian Organ Donor Register
New Zealand, register at Organ Donation New Zealand
South Africa,
United States,
United Kingdom, register at NHS Organ Donor Register
Your generosity can save or enhance the lives of up to fifty people with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help by donating skin, corneas, bone, tendon, ligaments and heart valves
Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes and 18 people die each day waiting for an organ or tissue transplant. Organs can save lives, corneas renew vision, and tissue may help to restore someone's ability to walk, run or move freely without pain. Life Begins with You.

No comments: