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
    0

    Comment number 17.

    I will assume that the comment from WendyRainbow at post 1 is a tasteless joke.

  • rate this
    +2

    Comment number 16.

    Sometimes, the comments on medical issues can be pretty callous. I know, because I'm usually one of the 'callous' ones.

    But this is different. Anything which gives people suffering from something this horrible the chance of a reasonable life is to be welcomed.

    Sooner see the money spent on this than on translation work for foreigners, for example.

  • rate this
    +7

    Comment number 15.

    1. WendyRainbow

    We should do all we can to prolong and improve the lives of those people who are already here. Medical research is one of the most important things we can do, and any progress is welcome.

    However, we should take steps to lower our birth rates, so we can reduce our population gradually and painlessly.

  • rate this
    0

    Comment number 14.

    9.solomondogs (commenting on No.1)
    ..., it's not PC which can't be a bad thing and it will attract bile from those who think all humans should live to a ripe old age,
    -
    What average lifespan would be 'right'? About 70-80 has been the the UK life expectancy for a long time IF infant mortality is taken out of the equation. I doubt if the majority of lung transplants occur among the over 70s

  • rate this
    +1

    Comment number 13.

    Cool !

    Just the issue of, er, price and hence availability in the UK.

  • rate this
    -7

    Comment number 12.

    The Cystic Fibrosis trust has spent tens of millions of pounds on gene therapy (replacement of the faulty gene in the lungs of sufferers). Why did all that research fail? Why are the medics and academics who took all the money raised by an army of volunteers and CF patient's family members never ever held to account? All those clever clogs achieved nothing.

  • rate this
    +3

    Comment number 11.

    1 (Wendy Rainbow)
    If the reconditioning can be shown to be effective and safe for the recipient within the usual parameters for transplants, then of course it should be adopted. Just as an example, razing Las Vegas to the ground would, with its vast and mainly wasteful carbon footprint, allow environmental headroom for an awful lot of lung washing and re-use

  • rate this
    +6

    Comment number 10.

    Wendy rainbow
    There is a pretty big carbon footprint in my lungs but anyone can have them or anything else once I have shuffled off.

  • rate this
    +1

    Comment number 9.

    Wendy rainbow,comment 1

    I find it hard to disagree with your comment, its not PC which can't be a bad thing and it will attract bile from those who think all humans should live to a ripe old age, the problem with that of course is a ripe old age is only good for us, its not good for anything else on the planet.

    It wasn't long ago that this sort of thing came under the 'horror' genre...

  • rate this
    0

    Comment number 8.

    I carry a donor card everywhere, but I don't think my lungs would be very useful! At least they've generated lots of tax.

  • rate this
    +6

    Comment number 7.

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

  • rate this
    0

    Comment number 6.

    There just might be a way to speed up "manufacturing" a patents replacement organs using recently released technology.

    A person had a jaw replacement, but this was made of Titanium.

    Perhaps a lattice could be printed out using a 3D Printer.
    Using carbon fibre (as a scaffold), 3d Body parts could be built complete with capillaries where blood vessels could also be printed, using stem cells.

  • rate this
    +6

    Comment number 5.

    WendyRainbow - I understand your point about extending life beyond normal lifespan and the added pressures on the planet. But this particular medical intervention is to give CF sufferers something like a normal lifespan which is only about 35 Years without treatment.

  • rate this
    +5

    Comment number 4.

    During the 80's I worked on trials of both immuno-suppressants & CF therapy. In both within a year we were not measuring life-span in months but in terms of people back to work (earning), getting married & having children. This research gives further hope for the many facing CF and as Bluesberry states provides human faces for the need for organ donors.

  • rate this
    +4

    Comment number 3.

    Giving a face to need for transplants, touches the heart; I carry a donor-card. Yet the ability to grow organs, place them into originating host, would eliminate shortage of transplant organs with their relatively short life-span, suppressing drugs, & illusion of long-lasting resolution. Reconditioning lungs - any organ - should not the priority; growing organs should be the priority.

  • rate this
    +5

    Comment number 2.

    I know my comment will seem callous.
    Transplants usually do not work - at least for very long. Then there is the constant need for suppressing drugs to prevent rejection. If all this money were devoted to stem-call research, growing new parts as they are needed for specific patients, there would be no rejection & much better results.

  • rate this
    -16

    Comment number 1.

    This is very good news for the individuals but not such good news for the environment or for climate change, increasing population results in increasing demand & no one has a carbon footprint of zero. It is time to ask ourselves if it is time to stop medical intervention, both in undeveloped countries & also in developed countries where people are able to live well beyond their natural span.

 

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