Ex-vivo Lung Perfusion

Description

If EVLP is successful, research into this method could reduce the number of donor lungs that are wasted – currently around 80% – and slash the waiting time for people on the transplant register.

Many people with cystic fibrosis will reach a stage where a lung transplant is vital for their survival, and one in three of those people will lose their life while waiting for a suitable donor organ to become available.

EVLP involves keeping donor lungs ‘breathing’ outside of the body and providing them with nutrients and blood-substitutes. This method also removes donor white blood cells resident in the donor lungs, which could play a part in reducing the recipient’s immune response and therefore minimise the risk of rejection.

If successfully introduced, this technique could mean that fewer donor lungs are wasted and the waiting time for new lungs could be reduced, saving lives and allowing people who need new lungs to get them sooner and recover more quickly.

Research

With a grant from the Robert Luff Foundation, the Trust has funded research led by Professor Andrew Fisher into why some lungs respond well to EVLP while others do not. Professor Fisher’s team is looking for biological characteristics, or biomarkers, that will identify donor lungs that are likely to respond best to the technique. Professor Fisher says “Putting lungs on EVLP is not without resource implications, so if we can do it in a more scientific way it will make EVLP more efficient.” This follows on from the earlier DEVELOP-UK study, samples from which are being used in the current research and other projects.

The grant from the Robert Luff Foundation has also been instrumental in leveraging significant additional external funding for Professor Fisher’s research team.

Back in CF Week in 2013, the Trust spoke to Philippa, one of the first people to receive a transplant in the EVLP pilot. Philippa said “My life is so much better now I’ve had my transplant; thanks to research funded by the Cystic Fibrosis Trust I got my call.”

Dr James Fildes’ research team at the University of Manchester has also benefitted from this funding, and in September 2015 they announced that by using EVLP on a trial in pigs they saw very little evidence of acute rejection in the donated organs, compared with severe rejection seen in all lungs transplanted using traditional methods. It is thought that this could be due to EVLP removing the donor’s white blood cells from the organ prior to transplantation and therefore reducing the risk of a severe immune response.

Dr Fildes announced the results of this research at the Trust’s UK CF Conference 2015  – watch this session to hear his speech.

Dr Janet Allen, Director of Strategic Innovation at the Trust, said “It’s an important development in transplant research, an area the Cystic Fibrosis Trust has been funding for several years, and will hopefully contribute to the rate of survival for transplant patients in the near future.”