In a breakthrough study, surgeons at Toronto General Hospital, University Health Network have successfully repaired an injured donor lung, unsuitable for transplant, and then transplanted it into a patient.
The team led by Dr. Shaf Keshavjee have developed an "ex vivo" or outside the body technique capable of continuously perfusing or pumping a bloodless solution containing oxygen, proteins and nutrients into injured donor lungs.
The technique called the Toronto XVIVO Lung Perfusion System, allows the surgeons to assess and treat injured donor lungs, while they are outside the body, to make them suitable for transplantation.
Unlike the conventional cooling lung preservation techniques, the Toronto technique maintains donor lungs at a normal body temperature of 37 degrees Celsius, allowing for future organ repair and gene and cell therapy strategies to be used on them.
Until now four patients in total have received lungs treated using this technique, and all have done well.
Currently only about 15-20pct of donor lungs are acceptable for transplantation since lungs are susceptible to injuries during the brain-death process or from intensive care unit-related lung complications.
These numbers can easily be doubled with this technique to treat and improve donor lungs.
"This new technique heralds the beginning of a new era in transplantation since it has allowed us to progress from preserving donor lungs to actually being able to repair some of the injury before transplantation," said Dr. Marcelo Cypel, a transplant surgical fellow at TGH.
"And we have done this using a unique strategy on donor lungs outside the body," Cypel added.