Breakthrough in Lung Transplant Methodology

A woman living with LAM in Queensland alerted us to this exciting news reported in the Brisbane Courier Mail on 05 February 2012.

BRISBANE surgeons have performed an Australian first, repairing donated lungs before transplanting them into a Queensland grandmother. The new technique, performed at Prince Charles Hospital, is expected to increase lung transplantation rates in excess of 30 per cent.

Of the 68 lungs donated in Queensland last year, only 25 were able to be used.

“Now we can use lungs that have an injury from chest trauma, carry infection or fluid using this technique,” said Queensland Lung Transplant Service director Dr Peter Hopkins. “We can improve the lung and make it healthy.”

The first successful transplant of repaired lungs was performed on 57-year-old Mackay grandmother Sandra Afflick. She is now walking kilometres each day after having no complications after her surgery.

“I have been going downhill for the past six years,” Ms Afflick, who suffered from emphysema and asthma, told The Sunday Mail. “I was down to 20 per cent lung capacity, needed oxygen every night and could barely walk 100m.” Now she can’t wait to go home and play with her grandkids Bailey, 5, and Tamiah, 7.

The Xvivo technique works by flushing the donated lungs in a bath using a nutrient solution for 22 hours to remove any infection or fluid and repair bruising. The nutrient solution is called the “Steen solution”, named after the Norwegian professor who developed it a decade ago. The solution holds proteins and nutrients capable of carrying oxygen – the lifeblood of the lung.

“Often lungs soak up fluid when people are critical in hospital before organ retrieval,” Dr Hopkins said. “We can now remove that fluid, repair bruising and flush out infection.”

Donated lungs arrive on ice and are placed in the bath with the windpipes attached to a ventilator. The pulmonary arteries and veins are attached to circuitry to keep them functioning or “alive”. They are then slowly “warmed up” and the cleansing process begins.

“One of the advantages of this technique, apart from increasing the donation rate, is that we usually have a window of around three to four hours to perform a transplant,” Dr Hopkins said. “Now we have a 22-hour window, allowing us to provide transplants to more remote patients and to perform surgery during daytime hours and avoid fatigue-related problems.”

The Prince Charles Hospital has a dedicated theatre established to repair lungs for transplantation. Lung transplant experts from Melbourne and Sydney will soon visit the hospital to learn about the technique.

Dr Hopkins said the new “flushing” technique minimised the chance of the donated organs being rejected and reduced the possibility of infection or other problems after the operation. The technique is being used in Canada and Sweden, where more than 16 repaired lungs have been transplanted, all successfully, without complications or rejection.

Prof Allan Glanville, head of the Cardio-Thoracic Unit at St Vincent’s Hospital Sydney has greeted the development of a technique for reconditioning lungs for transplantation as “a great leap forward”. He said St Vincent’s is negotiating the purchase of the equipment after visits to Prof Steen in Lund, Norway last year.