‘Lungs in a Box’ could boost vital transplants

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‘Lungs in a Box’ could boost vital transplants

Royal Papworth Hospital placed donated lungs inside a special dome-shaped incubator. The dome is plastic and you can see the tubes carrying liquid oxygen and nitrate going into the trachea of ​​the lungs. They are being inflated with a ventilatorRoyal Papworth Hospital
The machine, nicknamed “Lungs in a Box”, is designed to mimic the human body

Surgeons hope a new machine that keeps lungs alive outside the body could “change” the number of people getting transplants.

The success at Royal Papworth Hospital in Cambridgeshire comes after it became the first hospital in the UK to trial the use of the XPS system.

The machine, nicknamed “Lungs in a Box”, mimics the human body and surgeon Marius Berman said it could increase the number of transplants by 30%.

Daniel Evans-Smith, a 49-year-old events manager from Northampton, was the first person to receive a double lung transplant using the system on the NHS and said he was “extremely grateful”.

Daniel Evans-Smith, of Royal Papworth Hospital, looks at the camera from his hospital bed. He is wearing a hospital gown and has a blanket over his shoulders. He had a beard and gray hair. You can see the oxygen pipes in the background which are not connected to Mr Evans-SmithRoyal Papworth Hospital
David Evans-Smith had a double lung transplant in the summer and hopes to return to work in three to six months

About 81% of lungs are rejected for transplant. Because they are swollen or their condition is bad.

The machine improves the health of the organs by using a ventilator to inflate and deflate the lungs. A fluid containing nutrients and oxygen is also pumped through them.

This technique is called ex vivo lung perfusion (EVLP). This means that donated lungs that are considered “borderline” for use can be repaired and used rather than discarded.

The organs are kept at body temperature for six hours.

The one-year pilot is funded by NHS England and the Royal Papworth Charity.

This machine had previously been used only in UK research trials.

Royal Papworth Hospital Daniel Evans-Smith lies on a bed in the operating theater of the Royal Papworth Hospital. His eyes are open and a band is tied around his wrist and he is looking at the ceiling. A surgeon stands behind him wearing a hair net and scrubs. Two nurses checking equipment to his left and wearing scrubs and apronsRoyal Papworth Hospital
Mr Evans-Smith waited eight weeks for a transplant using the machine. The average wait in the UK is 18 months

Professor Derek Manns, NHS medical director of blood and transplant, said there was “growing evidence” that the technology could “enable more transplants by improving organ function”.

despite Change in law on organ donation consent In 2019, the hospital said there was a shortage of donated lungs, so the machine was making the most of the available lungs.

Professor Manas said more than 200 people were waiting for lung transplants, which is “significantly” more than the number of suitable donor organs.

Having the lungs “live” outside the body also allows surgeons to test the organs, meaning transplants have a better chance of success.

Royal Papworth Hospital Daniel Evans-Smith sits in a wheelchair outside the Royal Papworth Hospital. He is looking towards the camera and two female staff members in white uniform are standing behind him. He is wearing a mask on his face. Mr Evans-Smith has an oxygen tube stuck in his nose and tape on the side of his face. He is wearing a black T-shirt and gray jogging bottoms.Royal Papworth Hospital
Mr Evans-Smith spent three weeks in the critical care department after his transplant and took medicines to stop his body rejecting the lungs

Mr Evans-Smith quit smoking 12 years ago but developed chronic obstructive pulmonary disease (COPD), a lung condition that causes difficulty breathing.

He suffered five lung collapses and spent a total of six months in the hospital before receiving a transplant.

He was about to be discharged when the nurses woke him up and told him that donor lungs had been found.

The organs were placed on ice and transported to Cambridge, where they were placed in a machine to be “reconditioned” before transplantation.

David Wojtowicz/BBC Daniel Evans-Smith walks up the stairs to his flat in Northampton. She is holding a cream bannister and is wearing a green woolen jumper and navy corduroy trousers. His beard is slightly curled and his hair has turned grey.David Wojtowicz/BBC
Mr Evans-Smith can now climb the stairs to his flat thanks to his new lungs
Nikki Fox/BBC Surgeon Marius Berman stands in the critical care department of the Royal Papworth Hospital in Cambridgeshire. There are blue curtains on either side of him and some monitoring computers in the background that are blurry. He is wearing blue scrubs and metal glasses. He is looking straight at the camera with short white hair.Nikki Fox/BBC
Surgeon Marius Berman hopes the positive results of the 12-month pilot project will mean funding will continue

Marius Berman, surgical head of transplant at Royal Papworth Hospital, said he was “very proud to be the first UK hospital to use this machine” in addition to clinical trials.

Other technology exists, but surgeons said the simplicity of the machine allows people to train quickly and some options require the surgical team to travel to the donor, which can be costly.

He said 30% of people on the lung transplant list died and Mr Evans-Smith had a “very small window of opportunity”.

“Daniel would not be with us today without the lung transplant, and we could not perform lung transplants without the EVLP,” he said.

Royal Papworth Hospital performs more lung transplants than any other center in the UK, with 41 completed last year.

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Related Internet Links

Royal Papworth Hospital

NHS Blood and Transplant

transplant
organ donation
Health
Royal Papworth Hospital
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Northampton

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