Scientists from UCLA performed the nation's first
"breathing lung" transplant. The patient, a 57-year-old who suffered
from pulmonary fibrosis — a disease in which the air sacs of the lungs are
gradually replaced by scar tissue — received two new lungs and is recuperating
from the seven-hour surgery.
The lung transplant team at Ronald Reagan UCLA
Medical successfully performed the nation's first "breathing lung"
transplant in mid-November. The patient, a 57-year-old who suffered from
pulmonary fibrosis — a disease in which the air sacs of the lungs are gradually
replaced by scar tissue — received two new lungs and is recuperating from the
The groundbreaking transplant involved an
experimental organ-preservation device known as the Organ Care System (OCS),
which keeps donor lungs functioning and "breathing" in a
near-physiologic state outside the body during transport. The current standard
involves transporting donor lungs in a non-functioning, non-breathing state
inside an icebox.
With the OCS, the lungs are removed from a
donor's body and are placed in a high-tech OCS box, where they are immediately
revived to a warm, breathing state and perfused with oxygen and a special
solution supplemented with packed red-blood cells. The device also features
monitors that display how the lungs are functioning during transport.
"Organs were never meant to be frozen on
ice," said Dr. Abbas Ardehali, a professor of cardiothoracic surgery and
director of the heart and lung transplantation program at Ronald Reagan UCLA
Medical Center. "Lungs are very sensitive and can easily be damaged during
the donation process. The cold storage method does not allow for reconditioning
of the lungs before transplantation, but this promising 'breathing lung'
technology enables us to potentially improve the function of the donor lungs
before they are placed in the recipient."
UCLA is currently leading the U.S. arm of the international,
multicenter phase 2 clinical INSPIRE study of the OCS, developed by medical
device company TransMedics; Ardehali is the principal investigator for UCLA.
The purpose of the trial is to compare donor lungs transported using the OCS
technology with the standard icebox method. The INSPIRE trial is also underway
at lung transplant centers in Europe, Australia and Canada and will enroll a
total of 264 randomized patients.
According to Ardehali, in addition to potentially
improving donor-lung function, the technology could help transplant teams
better assess donor lungs, since the organs can be tested in the device, over a
longer period of time.
In addition, it could help expand the donor pool
by allowing donor lungs to be safely transported across longer distances.
"For patients with end-stage lung disease,
lung transplantation can dramatically improve the patient's symptoms and offer
relief from severe shortness of breath," said Dr. David Ross, professor of
medicine and medical director of UCLA's lung and heart-lung transplantation
program and UCLA's pulmonary arterial hypertension and thromboendarterectomy
program. "The 'breathing lung' technology could potentially make the
transplantation process even better and improve the outcomes for patients
suffering from lung disease."
The "breathing lung" device follows on
the heels of TransMedics' "heart in a box" technology, which delivers
donor hearts in a similar manner. The multi-center national study of the heart
technology, also led by UCLA, is ongoing.
Results of a preliminary OCS lung study conducted
in Europe were published in the Oct. 10 edition of the journal Lancet. The
findings showed good lung transplantation outcomes following preservation using
the OCS system.
UCLA's lung and heart-lung transplant program is the
largest lung transplantation program on the West Coast and leads the nation in
patient outcomes. The program pioneers novel technologies in lung preservation,
recipient immune monitoring and immunosuppression and is responsible for
significant advances in transplantation for extremely ill and high-risk