First “Breathing Lung” Transplant on East Coast Using OCS Lung Performed

First “Breathing Lung” Transplant on East Coast Using OCS Lung Performed

McGowan Institute for Regenerative Medicine faculty member Christian Bermudez, MD, UPMC’s chief of cardiothoracic transplantation and assistant professor of surgery at the University of Pittsburgh School of Medicine, is the principal investigator of a study where UPMC surgeons performed a “breathing lung” transplant using a portable machine that provides a constant supply of blood and nutrients to the donor organs. Doctors say this has the potential to keep donor lungs healthier and viable for longer than ever before.

The double-lung transplant was performed at UPMC Presbyterian, using the Organ Care System, also known as the OCS lung, by TransMedics Inc. This is the first time the device has been used on the East Coast. The patient, a 53-year-old man from Moundsville, W.Va., had suffered from pulmonary fibrosis and pulmonary hypertension. He was in good condition 2 days following the procedure.

Traditionally, donor lungs are cooled and put on ice with no blood circulation, a process that essentially puts them to sleep. Once removed from a blood supply, though, the lungs can deteriorate rapidly, which can lead to complications for the recipient or, in some cases, the determination that the organs are no longer viable. Using the OCS device, the lungs are immediately placed in the machine after donation, where they are kept at body temperature and functioning while in transit to the recipient.

“Unfortunately, many people waiting for an organ transplant die because usable donor organs aren’t available. Using this method, we believe we can help more people and save lives,” said Dr. Bermudez who participated in the transplant surgery along with surgeon and McGowan affiliated faculty member Jonathan D’Cunha, MD.

UPMC surgeons hope to enroll 10 patients in the clinical trial, which will randomize 5 participants to get the OCS device and 5 to be treated using the traditional method of care. The goal is to assess whether perfusing the lungs in the machine will decrease the chances of early dysfunction of the transplanted organ, thus resulting in better long-term function for the recipient.

“This is an exciting technology breakthrough that has the potential to increase the organ donor pool and improve outcomes for those receiving these specially perfused lungs,” said McGowan Institute for Regenerative Medicine affiliated faculty member James Luketich, MD, chair of the Department of Cardiothoracic Surgery.

The OCS lung machine resembles a small cart on wheels. It can monitor the organ’s arterial pressure, gas exchange ratio, vascular resistance, and other data through embedded sensors so doctors can get an immediate snapshot of the organ’s viability.

UPMC has a long history of innovation in transplantation, and surgeons have performed more than 3,000 heart and lung transplants. In 2007, UPMC surgeons were the first in the U.S. to perform a transplant in which a donor heart was maintained in a beating state for 2 hours and 45 minutes before being implanted into its recipient. That transplant used a similar perfusion machine developed for heart transplantation by TransMedics Inc.

Illustration: University of Pittsburgh Medical Center.