PHILADELPHIA — Transplant surgeons at the Perelman School of Medicine at the University of Pennsylvania have successfully used a new technique that repairs damaged donated lungs that would have been unusable, allowing for successful transplantation of the reconditioned lungs into a patient. The patient, a 66-year-old man from the Philadelphia suburbs, was transplanted at the Hospital of the University of Pennsylvania (HUP) and is the first in the region to receive donated lungs using this new procedure.
“ Known as ex vivo lung perfusion (EVLP), the new technique is applied to donor lungs outside of the body before transplantation with the goal of improving recovery practices and expanding the pool of organs available for patients in need of lung transplantation.
Chronic lung disease affects 35 million Americans, results in 400,000 deaths, and causes a public health burden exceeding $150 billion each year. Lung transplantation is the only life-saving therapy for patients with end-stage lung disease, however, the procedure has limited availability because not all donor lungs are safe for transplantation. This shortage of donor lungs results in the death of 20 percent of lung transplant candidates awaiting transplant.
"In the U.S., only 15-20 percent of potential donors have viable lungs for transplantation," said Edward Cantu, MD, assistant professor of Surgery, Division of Cardiovascular Surgery, at Penn. "Donor lungs are susceptible to injuries from excess fluid accumulation, bacteria, or damage from intensive care unit-related complications, rendering them medically unsuitable for transplantation. EVLP is a new method that allows the transplant team time to accurately assess and optimize function of these injured donor lungs that would otherwise not be used. With this new technique, we could potentially double the number of usable lungs for patients awaiting transplantation." .
The process involves a 3- to 4-hour period during which the donated lungs are placed inside a sterile plastic dome attached to a ventilator, pump, and filters. The lungs are maintained at normal body temperature and perfused with a bloodless solution that contains nutrients, proteins, and oxygen. This can reverse lung injury and remove excess water in the lung. During the process, lung function is evaluated continuously on key indicators, such as how easily the lungs can exchange oxygen, airway pressure and lung compliance. Once determined to be suitable, the lungs are transplanted into a waiting patient.
"The EVLP technique is being used in Europe and Canada and this current case at Penn is part of a national clinical trial assessing the technique in the U.S.," said Cantu, who performed the experimental procedure.
Penn is one of six sites in the United States participating in the 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.
Since the inception of Penn Medicine's lung transplant program in 1991, nearly 800 successful lung transplants have been performed and many lives have been dramatically improved. In recent years, surgeons at Penn Medicine have performed more than double the number of lung transplants than any other transplant program in the Philadelphia region.
For more information on the trial, please visit PennMedicine.org/ExVivoLungPerfusion.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2013 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2013, Penn Medicine provided $814 million to benefit our community.