A multidisciplinary medical and engineering team at Columbia University and New York-Presbyterian Hospital has for the first time been able to maintain a fully functional lung outside the body for several days. Using an innovative cross-circulation platform the team was able to maintain the viability and function of the donor lung and the stability of the recipient over 36 to 56 hours. They used the advanced support system to fully recover the functionality of lungs injured by ischemia (restricted blood supply), and made them suitable for transplant.
The team was inspired by the critical need to expand the pool of donor lungs. Transplantation remains the only definitive treatment for patients with end-stage lung disease, but the number of donor lungs is much smaller than the number of patients in need, and many patients die while on the wait list. In addition, lungs quickly lose their function outside the body and during transport: four out of five lungs evaluated at transplant centers are rejected. If these lungs could be kept viable outside the body long enough, it would be possible to improve their function and use them for transplantation.
The Columbia team realized that ‘cross circulation’ — an abandoned surgical procedure used in the 1960s to exchange blood flow between two patients — could enable long-term support of living organs outside the body by providing critical systemic and metabolic factors that are missing from all current technologies. The team embraced this idea and devised an entirely new approach to support lungs outside the body long enough to enable therapeutic interventions needed to recover their health and normal function.
The researchers say their new platform could be readily extended to recover other organs that are in high demand for transplant or in need of repair, including livers and kidneys, and they have already begun studies in these directions.