Lungs; Transplant

UTSW is first in Texas to transplant lungs using new technology to make organs more viable

Lungs; Transplant

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Dr. Pietro Bajona assesses the lungs using the ex-vivo lung perfusion technology.

Transplant surgeons at UT Southwestern Medical Center have performed the first lung transplant in Texas using donated lungs treated with new technology known as ex-vivo lung perfusion (EVLP).

EVLP allows physicians to evaluate and recondition lungs, making lungs that would have been unsuitable for transplantation potentially viable. UT Southwestern is one of 16 medical centers in the country – and the only one in Texas – participating in a national clinical trial of the technology, which, if effective, could significantly expand the number of donor lungs available for transplantation.

“Currently, more than 70 percent of potential donor lungs are deemed unusable,” says Fernando Torres, M.D., Professor of Internal Medicine and Medical Director of the Lung Transplantation Program at UT Southwestern. “EVLP technology is an assessment tool that will allow us to evaluate organs that are marginal over an extended period of time. We can see how well these lungs inflate and deflate, see how well gas exchange is happening, and some of these lungs will be found to be suitable for transplant.”

Adds Pietro Bajona, M.D., Assistant Professor of Cardiovascular and Thoracic Surgery and Director of the EVLP Program: “Some of the lungs we see are clearly not usable because of infections, bad contusions, and so on, but with others, it’s simply not clear. We can put the questionable lungs in the machine, ventilate them, perfuse them with a special solution, and then after a few hours test them.”

EVLP is expected to increase the number of lungs available for transplant by 10 to 15 percent.

First Patient

John Herzig became the first patient in Texas to be transplanted with lungs that were evaluated with EVLP technology. The 58-year-old former Oklahoma school superintendent was forced to retire early because of deteriorating health due to pulmonary fibrosis.

Mr. Herzig had been on the waiting list for a week when a potentially viable set of lungs was donated. After examining the inside of the lungs with a bronchoscope, the EVLP team began running a fluid machine that provides nutrients and removes waste products through blood vessels of the lungs.

Pulmonologist Amit Banga, M.D., Assistant Professor of Internal Medicine, along with the rest of the EVLP team assessed the lungs, paying particular attention to three measures: the transfer of oxygen; pressure in the blood vessels; and compliance, which is a measure of the ability of the lung tissue to stretch and expand.

“The basic job of the lungs is to get oxygen into the blood, and that’s something we can assess and maybe even improve with this technology,” Dr. Banga says. “If the pressure in the blood vessels of the lungs is too high, that’s a sign of worsening, so we pay close attention to that. And we like the lungs to be like a nice balloon that expands appropriately and then goes back to its normal size.”

EVLP not only allows for careful assessment of the lungs but even improves their condition by providing an opportunity for excess fluid that has accumulated in the lungs to dissipate.

Increasing the Number of Organs

After about three hours, the team of physicians determined the lungs for Mr. Herzig were usable, and Matthias Peltz, M.D., Associate Professor of Cardiovascular and Thoracic Surgery and Surgical Director of Cardiac Transplantation and Mechanical Circulatory Support, led the team that performed the transplant.

“There are more lungs declined in the operating room than any other organ,” Dr. Peltz says. “Ex-vivo perfusion technology allows us to evaluate organs for transplantation that we either would not previously have considered or would have declined in the operating room. If the ex-vivo evaluation is favorable, we can then implant the perfused lungs, significantly increasing the number of available organs for our patients.”

Did You Know?

UT Southwestern is one of the leading medical centers in the country in lung transplants, having performed more than 60 each year for the past four years, and more than 500 lung transplants overall.

Physician Referral Information

UT Southwestern physicians offer consultations and treatment in more than 60 subspecialties. Recognizing that navigating through the many programs and resources at UT Southwestern can be challenging, the University established Patient and Physician Referral Services to assist external physicians and their staff with securing patient appointments. Offices may call one centralized phone number to schedule a consultation in any clinic or to fax patient records related to a referral. The UT Southwestern referral coordinator will work closely with the appropriate physician or clinic to coordinate the patient’s appointment, as well as contact the patient and referring physician’s office with the appointment details.

Call a coordinator today at 214-645-8300.