University scientists pilot process to slow organ deterioration

By Maya Shankar, Daily Staff Reporter
Published March 16, 2015

A team of University researchers is successfully keeping lungs alive outside the body — with the help of a new machine.

In a clinical trial, the University is working to evaluate a recently developed machine — called the XVIVO Perfusion System — to keep donated organs viable for transplant while they’re outside of the body. The machine was first developed in Sweden in 2011.

The trial is in collaboration with Gift of Life Michigan, an Ann Arbor-based organ donation non-profit, and the Henry Ford and Spectrum health systems.

When an organ is removed from a body under normal circumstances, the cells begin to deteriorate quickly, making the transplant process difficult. Not only do the organs have to be a match for the patient, doctors must also transplant the organs quickly before they are damaged.

The U.S. Food and Drug Administration approved the machine earlier this week for patients in need of a transplant.

Dr. William Lynch, University associate professor of surgery, said with the system, the lungs are able to remain healthy outside of a body for 15 to 16 hours, which gives surgeons more time to determine their viability for transplant.

“The main purpose is to get more lungs to transplant patients,” Lynch said.

Since the implementation of the system in 2011, nine other centers in the United States have been involved in this clinical trail, resulting in about 68 lung transplants.

The trial seeks to demonstrate the safety of the machine and the procedure to ensure the FDA requirements have been met. It also gathers data that will allow scientists to get an idea of the technique’s efficiency.

Through a process called ex vivo lung perfusion, the lungs are attached to a machine that keeps them alive outside of the body. One tube from the machine pushes fluid through the lungs, which pulls water out of the lung tissue and keeps it healthy. The other tube pumps air into and out of the lungs, allowing oxygen to circulate.

The machine was first used for a transplant at the University two weeks ago and involved transplanting lungs that were kept outside the body for 15 to 16 hours, almost twice the amount of time normally safe for lungs, Lynch said.

“Right now, we have about 15 to 20 minutes to decide if the lungs will work well in the patient,” Lynch said.

Since there is no time to observe the lungs before they are transplanted, surgeons are forced to be overly cautious.

Currently, only about 20 percent of available lungs are actually being transplanted. In the United States, there are about 1,600 to 1,700 lung transplants a year, but there are 160,000 people that would benefit from a lung transplant. There are about 8,000 lung donors, but less than 2,000 of them are being used.

University alum Fares Alghanem, a research assistant in the Extracorporeal Life Support Lab, said the trial could have lasting impacts for organ transplants.

“There’s a weird disconnect now,” Alghanem said. “We’re not using all the lungs available for transplant, but we’re not able to give transplants to everyone who needs it.”

In addition to keeping lungs viable outside a body, the machine also allows more lung transplants to occur.

“You can take the lungs for a test drive,” Lynch said. “By being able to take the lungs out and observe them for a few hours, surgeons would be able to confidently transplant the lungs that may get wasted currently because there is a slight doubt about them and not enough time to observe.”

Lynch said he is especially excited about the future possibilities that could arise from the clinical trial.

“The real interesting future is going to be when these kind of machines can support organs for a prolonged period of times,” Lynch said.

Currently, lungs can only be kept outside for hours, but it is a possibility that soon there will be ways to keep them viable for days.

“Conceptually, there’s no reason we can’t take a cancerous lung out of a person, keep them alive, cure the lung, and then put it back in”.

This clinical trial is a step in that direction, Lynch said, and the future of medicine could change dramatically with this new technology.

Alghanem said the research could allow for a type of organ bank, where organs are kept alive with machines like the XVIVO Perfusion System, and they could be readily available for transplant when needed.

“This type of cutting-edge research inspires you to want to push the boundaries of medicine even further,” Alghanem said.