Lung transplantation: a technique for doubling the storage time

Through conservation technique, the lungs can be kept 6 hours. A longer delay that does not affect the quality of the graft.

Today, lung transplantation is the treatment of last resort for patients with COPD , cystic fibrosis or pulmonary fibrosis. But without grafts, patients can not be saved. To remedy this lack, doctors have developed a new preservation technique that doubles the time to preserve the body, from 6 to 12 hours.
According to their research published in the Lancet Respiratory Medicine, Rehabilitation ex vivo grafts would push the boundaries of donation for transporting lungs over longer distances.

Better yet, these organs kept “alive” 12 hours thanks to the infusion of a solution containing oxygen, proteins and nutrients provide the same benefits to recipients than those preserved the usual 6 hours. Researchers from the University of Toronto have indeed shown that a year after the transplant, the longer kept lungs are the same quality as those who follow a traditional path.

More than a decade of practice
“We use ex vivo rehabilitation grafts as a standard technique for over 10 years for risks to donors and 300 patients have benefited from this technology, says Dr. Marcelo Cypel, thoracic surgeon at Toronto General Hospital (Canada). The lungs of donors are transported in the cold and then warmed up in the hospital before being studied and cooled again until they are transplanted. Since it takes about 4 hours to take stock of lung functioning, the storage time does not exceed 8 hours. ”

After ten years of use in Canada, the impact on the long-term this technique on the quality of transplanted lungs had not yet been estimated. The team of Dr. Cypel then reviewed the medical file of 906 patients who received a lung transplant in the last nine years. Among them, 97 were transplanted with stored lungs 12 hours.

The comparison between the two groups of patients shows that the average length of hospitalization in intensive care is similar. In addition, the risk of life-threatening complications inherent to the transplant and the one-year survival after transplantation did not differ between the two groups.

Even broader benefits
“It is important to remember that the ex-vivo lung rehabilitation mainly concerned the lungs in less good condition. In fact, many of these grafts were excluded from the transplant in the past. The fact that they behave the same way as conventional grafts suggests that this technique may provide additional benefits to the current conservation, “said Dr. Jonathan Yeung, one of the authors of the study.

Still, this technique should still marginal even several years since the maximum preservation time before lung transplantation is still unknown.