Lung transplantation is a difficult business partially because lungs, once collapsed, can develop a devastating atelectasis which often leads to unsuccessful operations. Hyperinflation of lungs at the time of harvest and during transfer is another insult to an already fragile organ. It has been long hoped that a more “natural” technique that keeps organ alive prior to transplantation can be developed to increase success rate. The MIT Technology Review is reporting that clinicians at the Toronto General Hospital have created a device, dubbed the Toronto XVIVO Lung Perfusion System, that should help with future transplantation.
From MIT Tech Review:
In an operating room at the hospital, the technology can keep a pair of human lungs slowly breathing inside a glass dome attached to a ventilator, pump, and filters. The lungs are maintained at normal body temperature of 37 °C and perfused with a bloodless solution that contains nutrients, proteins, and oxygen. The organs are kept alive in the machine, developed with Vitrolife, for up to 12 hours while surgeons assess function and repair them.
Normally, as few as one in ten lungs available for transplant is usable, and even those may not work properly when grafted. "The system allows you to assess the lungs, to diagnose what’s wrong with them, and then repair them," says Shaf Keshavjee, who directs the hospital’s Lung Transplant Program. "Therefore, we’re transplanting lungs that have a more predictable outcome."
The shortage of donor organs is partly the result of outdated preservation techniques. Organs are conventionally cooled after harvesting, which inhibits their function and poses risk of injury. While the Toronto system isn’t the first to eschew cooling preservation for lungs, it improves upon a technique to recondition nonviable lungs developed at Lund University Hospital, in Sweden. The Toronto system can maintain the lung outside the body for much longer and poses less risk of injury, according to the researchers. "We’re keeping it in a protective setting without adding more injury so it can begin to heal," says Keshavjee.
Here’s a video of a pair of lungs breathing inside the XVIVO device:
More from MIT Tech Review…
U Toronto press release: Breathing life into injured lungs: world-first technique will expand lung donor organ pool…