Lung storage technique offers ‘paradigm shift’ for transplants

The gold standard for storing lungs for transplant surgery is to place them in ice cubes in a cooler to keep them at about 4 °C (39 °F). But a review of lung transplant studies shows that storing donor lungs is even hotter, which would greatly extend the time they remain viable.

The first lung transplant was performed in 1963. From then on, when the lungs are removed from the patient, they are packed in a cooler filled with ice and rushed to the recipient’s location. Generally, this method keeps the lungs alive for about six to eight hours. Wondering if they could improve this time around, researchers led by a team of scientists at the University of Toronto Health Network looked back at data from decades-old experiments.

“The way we solve this problem is to find the optimal temperature for lung storage[by]looking at data from experiments done more than 30 years ago, lung transplant pioneers looked at very low temperatures, all the way up to body temperature, to see what would happen to the ideal lung Preserve the temperature,” said the study’s first author, Dr. Aadil Ali, an adjunct scientist at the Toronto General Hospital Research Institute.

The data showed that storing the lungs at 10 °C (50 °F), rather than the roughly 4 °C (39 °F) produced by ice in coolers, was far and away the best approach. In fact, a further study of 70 patients at hospitals in Toronto, Vienna, and Madrid showed that higher temperatures extended storage time to 36 hours.

“The clinical implications of this study are enormous,” said lead author Dr. Marcelo Cypel. “This is a paradigm shift in the practice of lung transplantation. I have no doubt that this will become the gold standard for lung preservation for the foreseeable future.”

Working with Ana Adreazza, a professor at the University of Toronto, the researchers found that the higher temperature worked well because it helped keep the lung cells’ membranes functioning and their mitochondria healthy. Mitochondria help generate energy at the cellular level and are a key component of organ health.

The discovery could have wide-ranging implications for lung transplant surgery. Due to longer storage times, lungs can now be transported over greater distances, which means more people have access to these organs. Increased storage capacity could also mean better scheduling of surgeries, and it could eliminate the need to drive other surgeries out of the operating room to accommodate lung transplants.

You can learn more about this breakthrough and another major advance in the field of lung transplantation from the researchers in the video below.

The study was published in new england journal of medical evidence.

source: University Health Network