Doctor Performs First NY 'Ex Vivo' Lung Transplants
A doctor at NewYork-Presbyterian Hospital/Columbia University Medical Center was the first in New York state and among the first in the U.S. to perform lung transplants that were assessed and reconditioned in the operation room, an ex vivo technique that could dramatically increase the availability of lungs for transplant.
The ex vivo technique uses oxygen, nutrients, and antibiotics, to assess and recondition donor lungs outside the body prior to transplantation.
The authors said that the “ev vivo” or outside-the-body approach involved removing lungs from a deceased donor, then enclosing them inside a transparent dome and connecting them to a cardiopulmonary pump and a ventilator.
The two women that received the transplanted ex vivo lungs were both from the New York metro area. One was age 59 and the other 60.
The researchers explained that the lungs were infused with nutrients and antibiotics for four hours and then gradually warmed to body temperature, ventilated, and oxygenated. This process resembles breathing as the lungs inflate and deflate.
Once the lungs were determined to be viable, they were immediately transplanted into the patients.
"Assessing lungs this way gives us a much more precise picture of how they should perform after transplant, and the reconditioning process may actually improve the chances of success," says Dr. Frank D'Ovidio, associate surgical director of the lung transplant program at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of surgery at Columbia University College of Physicians and Surgeons.
He explained that transplant surgeons traditionally relied on a less sophisticated assessment but now with the ex vivo method, not only can they see the lungs inflate and deflate, but they can also get “hard data on how they function by monitoring multiple parameters and ultimately making sure that the gas exchange is happening at the level it needs to."
While fewer than 30 percent of donor lungs are acceptable for transplantation the ex vivo procedure could increase the availability of donor lungs potentially doubling this figure as the process is improved says physicians.
"This has the potential to do for lung transplant what perfusion has done for kidney transplant. With the tool to better assess, recondition and possibly repair the organs, we can increase the number available to patients who desperately need them."