Re-conditioning lungs for transplant

 

A radical new technique in use in transplant centres across the UK aims to "re-condition" donor lungs and may help those on the waiting list like Sam Yates.

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Only those who have lived with Cystic Fibrosis (CF) or cared for someone with the condition can know what Sam Yates and Philippa Bradbury have been through.

CF is caused by a faulty gene and affects the lungs and digestive system, by clogging them with sticky mucus.

It causes devastating damage to the lungs and eventually a transplant is sometimes the only means of survival.

Both women feature in my report - which you can see by clicking above - about a new donor lung treatment which is being trialled by UK transplant centres.

Although we filmed Sam Yates walking in her garden, most of the time she uses a wheelchair because her lung function is so poor. Once it dropped to 30% she went on the transplant waiting list. Now it's down to 17%.

She told me: "Everything takes such a long time, from getting up in the morning to getting dressed. I refuse to give in, but I had to give up my teaching job and rely hugely on my family to help me."

She has been prepped and ready for a transplant on two occasions, only to find that the donor organs weren't of sufficient quality.

Philippa Bradbury's lung condition was equally severe and she was called for transplant four times - but each time the donor lungs were unusable.

Happily Philippa is one of 17 patients in the UK who have benefited from a new technique which uses re-conditioned lungs which would otherwise be rejected.

At present four out of five donor lungs are not used because they do not function adequately. These delicate organs are easy to damage and can be subject to infection.

The new treatment involves "washing" donor organs by connecting them for several hours to a modified heart and lung bypass machine.

The lungs are given oxygen and nutrients, can be treated with antibiotics to tackle infection, and excess fluid removed. You can read more about the technique, known as ex-vivo lung perfusion (EVLP) here.

EVLP was first carried out in Sweden 2007. A Canadian team carried out 20 lung transplants using the technique and published promising early results last year.

Surgeons in Newcastle have carried out eight EVLP transplants and now the five transplant centres covering the UK are adopting the technique in a three year study.

Professor Andrew Fisher who is leading the research team said they should know in just a year what impact EVLP is having on the number of lungs used for transplantation.

He added: "Worldwide about 100 patients have had lung transplants using this reconditioning technique. The medium outcomes are good but we don't have long-term follow-up and that's what this trial is about".

The team hope to have results within around four years which will give a strong pointer as to whether reconditioned organs will last as long as standard transplanted lungs.

Of course a transplant is not a perfect solution. Patients need to take powerful immuno-suppressants which have side-effects and can themselves damage the body.

Transplanted organs have a limited life-span. Prof Fisher said in Newcastle, average survival of CF patients was 10 years post transplant.

Donor lungs are currently in such short supply that it is rare for patients to get a second transplant. But if this technique is successful then it might mean patients getting another transplant in the future.

Philippa Bradbury says her life has totally changed since her transplant. Her lung function is normal and she no longer needs daily physiotherapy. Because her donor lungs are free of the CF gene, they do not fill with sticky mucus. She still has the condition, and it can affect other organs, but her lungs are free of it.

For now Sam Yates and her husband Luke must continue to wait. She dreams of returning to work and living a normal life.

It was a pleasure to meet them and I hope Sam's story will encourage more people to consider organ donation as a means of helping people like her.

 
Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this
    +1

    Comment number 37.

    If it works and has a good outcome, then why not?

  • Comment number 36.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    0

    Comment number 35.

    We wouldn't need reconditioned lungs if we had "opt out" instead of "opt in" organ donation.

  • rate this
    +3

    Comment number 34.

    7.
    angry_of_garston
    11 Hours ago

    What a shame they cannot recondition the lungs of the recipient without needing a doner

    --------------------

    With technology improving all the time, hopefully that is not too far off and would give a better quality of life. Good luck to the two ladies in the film.

  • rate this
    0

    Comment number 33.

    Those interested in the history of Cystic Fibrosis might like to look at the Wellcome Witnesses to Twentieth Century Medicine volume on this topic, freely available to download from :

    http://www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/volume20/index.html

  • rate this
    +2

    Comment number 32.

    I sincerely hope this re-conditioning of donor lungs can help more people who suffer with CF. It is a really debilitating disease and anything that can be done to help them has got to be a good thing. I carry a donor card with me and hope that when I am gone some of my organs can be of use to someone else who needs them.

  • rate this
    +4

    Comment number 31.

    //Warla
    13 Minutes ago
    My Daughter who is 3 next week has CF, and so far has had 5 operations because of the disease. I would do anything for her to have a happy and fulfilling life//
    All the best with that.

  • rate this
    +4

    Comment number 30.

    My Daughter who is 3 next week has CF, and so far has had 5 operations because of the disease. I would do anything for her to have a happy and fulfilling life, If prolonging her life due to medical advances offends some because of increased population, CO2 omissons, I personally and selfishly couldnt care because until it affects you personally you do not understand.

  • rate this
    +4

    Comment number 29.

    Can they do consciences for prime ministers @ co. ?

  • rate this
    +3

    Comment number 28.

    WendyRainbow et al: another good way to keep the population down would be to create a creature slightly higer up the food chain than us, like a flying tiger-shark or something. Aside from that I thought that the lass from Huddersfield who's life had been turned round by the trial was lovely: genuinely pleased that something good was reported this week!

  • rate this
    -1

    Comment number 27.

    Another suggestion to WendyRainbow as to how we could prevent the planet from being overcrowded - rather than stop the scientists finding new cures/ vaccines let us arrange for women to be sterilised after the birth of their first child. Ok you will still see an inrease in popualtion but it will slow it. We will never stop the population from growing so let people have lives that are worth living

  • rate this
    +4

    Comment number 26.

    WendyRainbow obviously knows no one with a debilitating genetic illness and confuses the catastrophic overpopulation of this planet that threatens us all with humane medical intervention to prevent a slow, painful & horrific death of a fellow human being.
    WendyRainbow, will you refuse medical help if you get ill with a curable disease? Medical research and contraception must go side by side.

  • rate this
    0

    Comment number 25.

    Wendy Rainbow does not like this on environmental raesons - too many people on our planet - but this is to my mind a bit like reusing peoples lenses when they die as it is just enhmacing peoples lives. OK let us stop inventing new medicines as we are stopping what was once seen as natural selection when famines, natural disasters and plagues killed people and that will help with the overcrowding

  • rate this
    0

    Comment number 24.

    12.Mike from Brum
    "Why did all that research fail?"

    Who said it has failed? They are still trialing. This is from March 2012
    http://www.ox.ac.uk/media/news_stories/2012/120316.html

  • rate this
    +2

    Comment number 23.

    Hopfully this will only be a stopgap measure until we are able to provide cloned organs or synthetic substitutes. That being said hopefully we can also make progress on alternate therapies to bring some of the current experimental ones into wider use as well

  • rate this
    0

    Comment number 22.

    A wonderful idea as it will help so many. I at least feel a bit better knowing that my lungs could be reconditioned for use for someone else when I die - the rest of me I am sure would not be good for spare parts. Okay WendyRainbow is against this on environmental reasons - too many people on the planet - but as these people are here already can we not give them a chance of a reasonable life

  • rate this
    +1

    Comment number 21.

    Politicians all have spare lung capacity so should all donate one lung for transplant to a needy person.

    I would prefer the surgeons to remove both but there is probably some well meaning organisation out there that thinks politicians have a right to exist and should be saved.

    Sad world.

  • rate this
    +1

    Comment number 20.

    17.david - I will assume that the comment from WendyRainbow at post 1 is a tasteless joke.
    Why would yoiu assume that it is a joke in bad taste, when I personally may not agree with it, but think that her points are very valid. We do at times intervene when we should allow nature and the natural process of death take its course. We shopuld alleviate suffering and pain where we can.

  • rate this
    +2

    Comment number 19.

    Wow, some nasty comments! Let's just be happy this might give some people relief from their illness!

  • rate this
    +4

    Comment number 18.

    Imagine a day where you could donate some cells and have a new organ grown for you and your broken one replaced.

    Or you break your back, but don't have to worry, as doctors can repair it with stem cells and you'll be on your feet in a week.

    Bring it on.

 

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