Storing donor lungs for transplantation at 10 degrees Celsius markedly increases the time the organ can live outside the body, according to research led by a team of scientists from the Toronto Lung Transplant Program at the Ajmera Transplant Center in the University Health Network (UHN).
Non-randomized, multicenter, prospective clinical trial study of 70 patients demonstrated that donor lungs remained healthy and viable for transplantation for up to four times longer compared to storage in the current standard of storage in coolers of around 4 degrees centigrade
“The clinical impact of this study is enormous. It is a paradigm shift for the practice of lung transplantation,” says lead author Dr. Marcelo Cypel, Surgical Director at Ajmera Transplantation Center and Surgeon at Sprott Department of Surgery. from the UHN.
“I have no doubt that this will become the gold standard practice for lung preservation for the foreseeable future.”
Currently, the lungs available for transplantation are limited by how long a donated organ can remain viable. Increasing storage time allows lungs from viable donors to come from greater distances, increasing the possibility that more lungs will be available for transplantation and many of the hurdles associated with transplant logistics will be overcome.
“In transplantation, we still see a critical shortage of organs and people dying on the waiting list because there aren’t enough lungs to transplant,” says Dr. Cypel, who is also a professor in the Division of Thoracic Surgery, Department of Surgery. . at the U of T
“It’s a great achievement to see that our research is now having an impact, and that we can actually have more cases treated at our center, with continued outstanding clinical results. Better organ preservation also means better patient outcomes.”
Results of the trial were published today in the New England Journal of Medicine Evidence.
The trial was conducted over 18 months at the UHN Toronto General Hospital, the Medical University of Vienna, and the Puerta de Hierro-Majadahonda University Hospital in Madrid.
“The ability to extend the life of the donor organ presents several advantages. Ultimately, these advantages will allow more lungs to be used in more distant geographies and the ability to improve recipient outcomes by making lung transplantation a more planned rather than urgent”. says the study’s first author, Dr. Aadil Ali, an associate scientist at the Toronto General Hospital Research Institute.
Some advantages of this new 10 degree Celsius standard for lung storage include the possibility of reducing or eliminating the 24/7 schedule and urgency of lung transplant procedures. By increasing the length of time donor lungs are viable, transplant surgeries could become planned procedures, avoiding scheduled surgeries and overnight transplants. This advance in practice comes at a critical time when hospital resources are stretched and there is an increase in surgical backlogs due to the pandemic.
The study also suggests that the new storage temperature will allow more time to optimize immunological compatibility between donor and recipient, and the possibility of performing a lung transplant semi-electively instead of urgently.
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