Toronto doctors develop method to preserve lungs for transplants

Medical researchers in Toronto have developed a way to repair damaged lungs that until now have been unsuitable for transplant.

Surgeons have always worked on lungs while they are still inside the donor's body, where doctors could cool the organs down to keep them suitable for transplant.

But the procedure had to be completed within a six-hour window or else the organs would die.

In the new technique developed at Toronto General Hospital, doctors found a way to work with lungs on the outside of the donor's body.

Dr. Shaf Keshavjee, director of the hospital's lung transplant program, and his colleagues created a bubble and put the lungs inside.

The life support system keeps lungs breathing for 12 to 18 hours at normal body temperature of 37 C.

"To see these lungs that were previously damaged that 12 hours later are perfect  is still fascinating to me, that we've been able to achieve that," said Keshavjee.

Lungs were not programmed to be taken out of the body and put into someone else, but the technique uses a bloodless solution of oxygen, proteins and nutrients to repair lungs that otherwise would be too damaged to use for transplants. 

Keshavjee said the team then uses its knowledge of lung injury, repair and regenerative medicine to help the lung to heal.

Patient walking, breathing easier

Andy Dykstra, 56, received his repaired lungs on Dec. 5. He had been waiting for a transplant since July 30.

"I can breathe easier," Dykstra said. "I haven't even done physiotherapy yet and I can walk farther than I could walk before."

Dykstra was invited to participate in the trial of reconditioned lungs the day before his transplant. He said he waited only two seconds before saying yes, noting he had no prognosis left without a transplant.

"When I was given this chance, the hair on my arms stood up, I was so excited. I knew it was right. I just had to go for it," he said in a statement.

Lung transplant successes, gaps

Currently, only 10 to 15 per cent of donated lungs are suitable for transplants. Keshavjee estimated the new technique could allow up to 60 per cent of lungs to be repaired and used.

The world's first successful lung transplant was performed in 1983 at Toronto General Hospital by Dr. Joel Cooper. The patient lived for another six years before dying of kidney failure at age 64.

On Thursday, the Canadian Institute for Health Information issued a report on progress in lung transplants since then. The number of lung transplants increased to 171 in 2006 from 93 in 1997. The three-year survival rate also improved to 80 per cent in 2003 from 60 per cent in 1997.

In Ontario, 60 to 80 patients are waiting for a lung transplant. Despite the advances, Keshavjee said about 20 per cent of people seeking lung transplants die while on the waiting list in Toronto.

The bubble technique could also have broader implications for transplanting other organs, such as livers, kidneys or the heart.

The clinical trial was funded by Vitrolife, a Colorado-based company that specializes in developing lung preservation solutions.