Groundbreaking research at the University of Virginia School of Medicine that aims to dramatically increase the number of lungs that can be used for transplant has received a $3.3 million grant from the National Institutes of Health.
The work seeks to use a drug developed at U.Va. to rehabilitate lungs that are currently deemed unusable. It could allow doctors, for the first time, to harvest, repair and use lungs from donors whose hearts are not beating, such as patients who have suffered cardiac arrest. It could also significantly increase the window of time when transplants are possible after lungs have been removed from the body, theoretically allowing a patient in Miami to receive a lung from a deceased donor in Seattle.
“We want to be able to utilize the much larger pool of potential donor lungs: the non-heart-beating donors,” said co-principal investigator Victor Laubach of U.Va.’s Division of Thoracic and Cardiovascular Surgery. “And if we can do that using this system, we can significantly reduce or maybe even eliminate the wait list for transplants. And that would save a lot of lives.”
Only 15 percent of donor lungs now end up being usable, Laubach said. The rest are discarded because they’re deemed unsuitable, often because the donor died outside a hospital, causing an unknown amount of damage to the lungs. “Fifteen percent is really a low, low number,” Laubach said. “That means there are a large number of patients on the waiting list for lungs, and many of those patients will die because they can’t get a lung in time.”
The U.Va. researchers, led by Laubach and co-principal investigator Dr. Irving L. Kron, are testing a drug, developed at U.Va., in combination with an existing technology called ex-vivo lung perfusion. Ex-vivo lung perfusion allows a lung to be removed from the body, connected to a machine and evaluated to determine how well it can function. U.Va.’s drug, meanwhile, has been shown to greatly reduce inflammation and damage to lungs in experimental transplantations. So the hope is that combining the two will allow doctors to rehabilitate and use lungs that now go to waste.
“There is an organ shortage due to the inability to use lungs that can be improved by this extraordinary new technology,” Kron said. “We believe this will translate to improved survival for patients with end-stage lung disease.”
The five-year, $3.3 million grant, from the National Institutes of Health’s National Heart, Lung and Blood Institute, will allow the U.Va. researchers to advance their studies, now using pigs, in hopes of one day applying the approach to humans.
The researchers also hope their work will extend the period that a lung is usable outside the body. Currently that window is typically six to eight hours; the U.Va. researchers hope to extend it to 24 hours or even longer.
In addition to supporting experimental pig lung transplant studies, this grant will also enable the U.Va. team to begin working with human lungs that are not used for transplant.
“Rather than being thrown away, we’re going to bring these lungs into the lab to see if we can rehabilitate them to actually make them usable,” Laubach said. “We can assess them and hopefully confirm the findings we see in the pigs. If it all goes well, one day down the road, we will start doing this in patients.”