A machine has been developed that can recondition a set of lungs outside of the body in order for them to improve and make them healthier ready for transplant into a recipient. The machine is known as ‘the box’ and it ventilates lungs after their removal from the donor. It also infuses them with a mix of fluid, drugs and steroids which allows the lungs to dry out and get them into a better shape before being transplanted.
“It allows the lungs to stay alive… and allows us as providers to assess the function of the organ in a unique, well-controlled environment,” said Dr. Varun Puri.
The machine is made up of a ventilator to help simulate breathing and a bypass machine to perfuse the lungs with drugs and fluid In order to improve their function and generally helps to mimic the body with one major helpful difference. The lungs normally undergo a lot of stress in the body constantly exchanging gases with every breath, however in this box that stress factor is removed and gives the lungs a chance to heal.
This machine will hopefully help to improve lung transplant statistics and aid in improving the long-term survival rates of those that suffer from respiratory diseases like COPD. Currently fewer than 20% of donor lungs are considered suitable for transplant and 25% of candidates dies whilst waiting for a transplant. Even the survival rate post-transplant is 50% to survive 5 years. This device could aid in increasing the donor pool as the machine can take lungs that were previously deemed as unsuitable and give them a chance to heal and improve, making them then viable lungs for transplantation. With more lungs available for transplant fewer patients will die waiting and if the lungs are healthier when transplanted then hopefully the survival rates for lung transplants will also improve with further research.
“I am sure in the future we will be able to do things like gene therapy to the lungs in a controlled environment or utilizing specific anti-inflammatory agents to prevent short term and long term rejection of organs.” said Dr. Varun Puri.
Michele Coleman, 63, credits ‘the box’ with saving her life. A former smoker, she was diagnosed with chronic obstructive pulmonary disease and doctors asked if she would participate in a clinical trial.
“You don’t want to, but you kind of lose hope because when you are sick like that you know how fast you are going downhill,” Coleman said. “It’s scary, but anything that they could give me was going to be better than I had, and actually I figured I wouldn’t make it to the end of the year,” she said. The transplant for her was a huge success and she is still doing well with her ‘reconditioned’ lungs.
There is also hope of being able to do the same with other organs to improve transplantation survival rates across the board. Hopefully ‘the box’ brings a little light to those with severe respiratory diseases where their lungs are failing them.