Future lung transplants may become more readily available and potentially more beneficial for recipients after a successful, groundbreaking procedure last month at the Ronald Reagan UCLA Medical Center.
Fernando Padilla Jr., a 57-year-old carpenter suffering from pulmonary fibrosis, received a double lung transplant using experimental technology that could lead to a major transformation of the transplant field. Pulmonary fibrosis is diagnosed when scarring in a patient’s lungs has no known cause. When lung fibrosis is caused by asbestos exposure, it is diagnosed as asbestosis.
Padilla received the nation’s first “breathing lung,” which is in contrast to the non-breathing, non-functioning lung that arrives in cold storage and is the current standard for transportation from donor to recipient.
The team at UCLA was using the Organ Care System (OCS), an organ preservation device that keeps the lung functioning and breathing outside a body during transport. It is done after the lungs are removed from a donor’s body and revived to a breathing state with oxygen, new technology and a solution that includes red blood cells. The device also can monitor how the lungs are functioning during transport.
“Organs were never meant to be frozen on ice,” Abbas Ardehali, M.D., director of the heart and lung transplantation program at UCLA, said in a press release from the school. “Lungs are very sensitive and can easily be damaged during the donation process.”
Breathing Lung Could be New Transplant Standard
The “breathing lung” technology, in contrast to the current standard of transport, has the potential for allowing doctors to improve the functioning of donor lungs before they reach the intended recipients. They also have the likelihood of expanding the donor pool. The lungs can be transported from longer distances and for longer periods before transplanted to the recipients.
The transplant at UCLA was part of a multi-country clinical study of OCS, which is being made by TransMedics, a medical device company. It also is being tested in Australia, Canada and a few European countries. The purpose of the study is to compare the success of the OCS method to the current cold storage method.
According to a report by ABC news, Padilla is doing well two weeks after receiving the transplant during a seven-hour operation. He is breathing without the aid of oxygen, and up on his feet feeling normal again.
Ardehali told ABC that only 30 percent of all donated lungs actually can be used for a transplant, leaving many patients to die while awaiting a new lung. He believes this new transport method, and the ability to improve the function of the lungs, could make more lungs available to potential recipients.
Pulmonary fibrosis is a disease that makes the lungs ineffective when scar tissue replaces the air sacs. It’s one of several conditions that can lead to the need for a lung transplant to stay alive.
Successful lung transplantations have been done since 1983 as an effective option for end-stage lung disease. UCLA has been one of the leaders in the field, doing its first lung transplant in 1988.
UCLA also is the home of renowned surgeon Robert Cameron, M.D., a pioneer in the treatment of pleural mesothelioma, the cancer caused by asbestos exposure that affects the thin lining surrounding the lung. Cameron was instrumental in the opening of the Pacific Meso Center in Los Angeles.
UCLA Leads in Transplant Technology
The Organ Care System is similar to the “heart in a box” technology, which works in a similar fashion for heart transplants. UCLA also also has helped pioneer that technology. The program at UCLA is a national leader in helping high-risk transplant candidates, along with developing new technology for lung preservation and recipient immune monitoring.
“For patients with end-stage lung disease, lung transplantation can dramatically improve the patient’s symptoms,” Davis Ross, M.D., medical director of the UCLA Heart and Lung Transplantation Program, concurred in the press release. “The breathing lung technology could potentially make the process even better, and improve the outcome for patients suffering from lung disease.”
The team at UCLA has performed more than 450 lung transplants. Recent improvements in post-transplant care left Ardehali talking about increasing the volume of transplants, particularly with the new Organ Care System now becoming available.
“The number of suitable donor lungs will rise with the Organ Care System, and we’ll be able to treat a larger population,” Ardehali said.