Friday, June 1, 2012

'Lung washing' may up transplants

"Washing" lungs before they are transplanted could increase numbers of the organs suitable for donation, according to doctors in Newcastle.

Only one in five donated lungs are good enough to be transplanted safely.

A trial, being led by Newcastle University, is trying to improve the quality of the lungs by pumping nutrients and oxygen through them.

The British Transplantation Society said the technique could "dramatically" increase the number of lungs used.

Around a quarter of people waiting for an organ transplant die in the first year on a transplant list.

The lungs are delicate organs and the events which lead to a donor's death can also damage the lungs. It is why so few can be transplanted.

Spruce up

Doctors are using a modified heart-lung bypass machine to prepare the organs. Air is pumped into the lungs, which can absorb oxygen, while nutrients are pumped through the blood vessels.

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How many will be usable is unknown. If it is only half that's still a 50% increase in the number of lung transplants and that's going to make a huge difference?

End Quote Prof Andrew Fisher Trial leader

The technique called "ex-vivo lung perfusion" can clear a build-up of water on the lungs or can treat them with medication to clear infection.

Prof Andrew Fisher, who is leading the trial, told the BBC that the technique allows doctors to monitor lungs to see if their function improves and become suitable for transplant.

"It won't undo permanent damage, such as from emphysema, but it helps lungs that should be functioning well, but aren't."

He estimates that it will mean doctors can assess twice the number of lungs they currently do.

Prof Fisher said: "How many will be usable is unknown. If it is only half that's still a 50% increase in the number of lung transplants and that's going to make a huge difference."

He described improving the quality of organs as the "new frontier" for transplants after "mastering" surgery and rejection drugs.

'Potential to transform'

Seventeen patients have already received lungs that have been prepared through this technique.

The trial is also taking place at NHS transplant centres in London, Cambridge, Birmingham, Manchester and Newcastle.

Doctors will need to check that there are no complications, such as more infections, as a result of the procedure.

Prof Chris Watson, the president of the British Transplantation Society, said: "Currently around a quarter of potential recipients die in the first year while waiting for suitable lungs and this study has the potential to transform that situation for the benefit of all the patients waiting for a lung transplant."

He thinks similar procedures will eventually be used for many organs: "I think it is something that will take off," he told the BBC.

The Cystic Fibrosis Trust is funding some of the research. Its chief executive Ed Owen said: "Sadly many people currently die before lungs become available.

"The ex-vivo lung perfusion research is revolutionary for people with cystic fibrosis as it makes more lungs available and therefore offers real hope and life for many people."

NHS Blood and Transplant said there was a "severe shortage" of organs and that ways of using donate organs more effectively were "desperately needed".

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