Donor lungs preserved outside the body using the hypothermic oxygenated machine perfusion (HOPE) method have shown promising results, even when kept out-of-body for close to 20 hours, according to recent research. This technique, though commonly applied to kidneys and livers and currently being trialed for hearts, has yet to be widely adopted for lung transplants.
Ex vivo lung perfusion (EVLP) gives physicians the capability to condition and observe donor lungs outside the body prior to transplant. During this process, the lungs are connected to a ventilator and a perfusion system that delivers a solution mimicking the body’s natural fluids, allowing for evaluation and, in some cases, functional improvement.
Jitte Jennekens, MSc, is a transplant coordinator and organ perfusionist at the UMC Utrecht in the Netherlands. He gave the study findings at the ISHLT Annual Meeting in Boston. The study comprised 12 transplant procedures in which donor lungs were preserved with a combined nEVLP-HOPE strategy and matched with a historical cohort of 118 transplants conducted between the years 2017 to 2022 without ex vivo perfusion.
"Although this technique has become popular in maintaining other organs, lung preservation has not been accorded the same attention so far," Jennekens said.
The study aimed to explore whether extending preservation times with HOPE could be safely achieved while maintaining lung viability.
UMC Utrecht created its HOPE protocol to allow lungs to be preserved overnight, thus making it feasible to carry out transplants during regular daytime hours. Typically, donor lungs are first stored on ice, then assessed through normothermic EVLP (nEVLP) at 37°C, and returned to ice afterward until surgery. The HOPE method adjusts this protocol by performing a one-hour nEVLP evaluation and then keeping the lungs at 12°C up to the point of transplantation without undergoing a second cold storage phase.
The results were encouraging: none of the lungs banked using the nEVLP-HOPE protocol were rejected and short-term results were compatible with the control group. These cases, treated between 2022 and 2024, were included in a logistical transition to assess HOPE's clinical practicability.
According to Jennekens, the next goal is to refine the approach based on the characteristics of specific donor lungs.
“Extending the time that lungs can be safely preserved outside the body opens up new possibilities, such as introducing targeted therapies to enhance donor lung quality before transplant,” she noted.
(Input from various sources)
(Rehash/Sai Sindhuja K/MSM)