Ex Vivo Lung Perfusion
Because so many donor lungs are damaged at the time of death, only 20-30% of donated lungs are usable for transplantation.
Ex vivo lung perfusion (EVLP), a process of evaluating and preparing donor lungs outside the body prior to transplant surgery, could significantly increase the available donor pool by restoring and repairing donor lungs that have sustained damage.
In EVLP, the lungs are warmed to normal body temperature, flushed of donor blood, inflammatory cells and potentially harmful biologic factors, and treated with antibiotics and anti-inflammatory agents.
Beginning in June 2011, the NOVEL Trial (Normothermic Ex-Vivo Lung Perfusion as an Assessment of Extended/Marginal Donor Lungs) began testing EVLP at NYP/Columbia University Medical Center under the direction of Principal Investigator Frank D'Ovidio, MD, PhD. Dr. D’Ovidio and members of the NYP/Columbia Lung Transplantation Program performed the first ex vivo transplant at this hospital in September, 2011, saving the life of 59-year-old Patricia Kingsbury.
Developed at the University of Toronto, the ex vivo method entails keeping the donor lungs outside the body for about four hours. During this time, the lungs are infused with a solution of oxygen and nutrients, and are carefully assessed for damage. In some cases, lungs that might have previously been deemed too poor for transplant can in fact be successfully replenished and repaired, rendering them usable. This technique has the potential to significantly increase the number of donor organs available for transplant — a benefit that could mean all the difference for patients like Patricia whose lives may well depend upon the availability of a donor organ.