Friday, July 18, 2014

Lung in a box


"It's revolutionary," says Jose Garcia, MD, surgical director of the Cardiothoracic Transplantation and Artificial Heart and Lung Program. “It is just that simple. This could potentially expand the number of people who receive lung transplants by 50 percent each year.”

The MGH has become the first hospital in New England to successfully perform what’s being called a “lung-in-a-box” transplant. In this procedure, the donor lungs are transported inside a portable organ-preservation device known as an Organ Care System, instead of being transported to the hospital in a cooler. While inside the “box,” the donor lungs are hooked up to a machine that perfuses the lungs with warm, oxygenated, nutrient-enriched blood.

The transplant was part of a clinical trial with the Massachusetts-based device manufacturer TransMedics.

“Once lungs are disconnected from their blood supply, the tissue immediately starts to deteriorate and continues to do so until the organ becomes unusable – generally at about six hours,” explains Todd Astor, MD, medical director of the Lung and Heart-Lung Transplant Program. “As a result, an estimated 80 percent of donor lungs globally cannot be used for transplantation because it would take too long to retrieve the organs and bring them back. With this device the lungs can go generally 12 hours before transplantation because they are being infused with blood and essentially breathing the whole time.”

Adds Garcia, “By doubling the time we have to retrieve the lungs and get them ready for transplant, we are giving ourselves a much bigger radius in which we can travel to retrieve the organs. That means we have the potential to drastically increase the number of usable organs. Hopefully, it will lead to a drastic increase in the amount of lives we can save.”

The MGH also took part in the TransMedics clinical trial for their “heart-in-a-box” technology in which patient Amy DeStefano became the first person in New England to receive her heart transplant in 2011.

Read more articles from the 07/18/14 Hotline issue.


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