Lung in a Box


More than 1,600 people in the U.S. are currently on the waiting list for a lung transplant.

Each year, hundreds of those patients miss the opportunity to receive an organ transplant because the donor lungs are either too far away or too damaged to be used. Now there's new hope.

Fernando Padilla is passionate about two things, his car and his family. But for more than two years, he wasn't able to enjoy either because he had pulmonary fibrosis. His lungs were slowly being covered by scar tissue. He was going through three tanks of oxygen a day.

"I would sit on the couch, and if I dropped something, it was a struggle for me to pick it up," explains Fernando Padilla a lung transplant patient.

A lung transplant was his only hope. When a donor was found, Fernando learned he'd make history by being the first man in the U.S. to get donor lungs that were still breathing.

"We can keep a human organ alive outside of a human body," explains Abbas Ardehali, MD, FACS, the Director at the UCLA Heart, Lung, and Heart-Lung Transplant Programs of David Geffen School of Medicine at UCLA.

The lungs are put in a high-tech box where they are revived to a warm, breathing state. A machine circulates blood and oxygen through it, allowing the lungs to be outside of the body for eight hours or possibly more.

"As far as the organ is concerned, it still feels like it is in a human body because it is still breathing," says Dr. Ardehali.

Now, Fernando is healthy and back in the driver's seat.

Before this invention, the traditional way to keep lungs was on ice in a cooler. The breathing lung device follows on the heels of heart in a box technology, which delivers donor hearts in a similar manner.

Experts believe other such donor organs will soon use similar devices.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: Lung in a Box
REPORT: MB # 3625

BACKGROUND: About 140,000 Americans have been diagnosed with pulmonary fibrosis. It usually affects people between the ages of 50 and 75. Pulmonary fibrosis is a disease marked by scarring in the lungs. Tissue deep in the lungs becomes thick, scarred, and stiff. That scarring is called fibrosis. In certain cases, the cause of pulmonary fibrosis can be found, but most are unknown. It can develop quickly or slowly, and there is not a cure. Most people with the disease only live about three to five years after diagnosis. It can lead to other medical problems, including collapsed lung infections, blood clots in the lung, and lung cancer. As the disease worsens, it can lead to respiratory failure, heart failure, and pulmonary hypertension. (Source: www.lung.org)

CAUSES: In most cases, the cause is unknown. However, there are certain things that increase the risk of developing the disease. They include:
* Certain viral infections
* Cigarette smoking
* Exposure to environmental pollutants, including hard metal dusts and silica
* Gastroesophageal reflux disease (GERD). Some people who have GERD may breathe in tiny drops of acid from their stomach, which can injure the lungs. (Source: www.lung.org)

TREATMENT: Treatments aim at preventing more lung scarring and relieving symptoms. They include: medication, like prednisone to reduce inflammation; pulmonary rehabilitation programs that teach people about their disease and how to manage their disease; and lung transplants. (Source: www.lung.org)

NEW TECHNOLOGY: First, there was the "heart in a box," a revolutionary experimental technology that allows donor hearts to be delivered to transplant recipients warm and beating rather than coming form an ice cooler. That same technology is now being used to deliver "breathing lungs." The lung transplant team at Ronald Reagan UCLA Medical successfully performed the nation's first "breathing lung" transplant in November 2012. The transplant involved an experimental organ-preservation device known as the Organ Care System (OCS), which keeps donor lungs functioning and "breathing" in a near-physiologic state outside the body during transport. With the OCS, the lungs are removed from a donor's body and placed in the box, where they are immediately revived to a warm, breathing state and perfused with oxygen and a special solution supplemented with packed red-blood cells. "Organs were never meant to be frozen on ice. Lungs are very sensitive and can easily be damaged during the donation process. The cold storage method does not allow for reconditioning of the lungs before transplantation, but this promising 'breathing lung' technology enables us to potentially improve the function of the donor lungs before they are placed in the recipient," Dr. Abbas Ardehali was quoted as saying. UCLA is leading a multicenter pivotal clinical INSPIRE study of the OCS, developed by medical device company TransMedics. The trial is underway at centers in Europe, Canada, and Australia and will enroll 264 patients. "For patients with end-stage lung disease, lung transplantation can dramatically improve the patient's symptoms and offer relief from severe shortness of breath," Dr. David Ross, Professor of Medicine and Medical Director of UCLA's Lung and Heart-lung Transplantation Program and UCLA's Pulmonary Arterial Hypertension and Thromboendarterectomy Program, was quoted as saying, "The 'breathing lung' technology could potentially make the transplantation process even better and improve the outcomes for patients suffering from lung disease." (Source: http://newsroom.ucla.edu/portal/ucla/ucla-performs-first-breathing-241056.aspx)

FOR MORE INFORMATION, PLEASE CONTACT:

Amy Albin
Sr. Media Relations Representative
UCLA Health Sciences Media Relations
aalbin@mednet.ucla.edu

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Andrew McIntosh at amcintosh@ivanhoe.com.


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