A machine that helps restore donor organs was used for the first time in a double-lung transplant in the UK
Exclusive: Daniel Evans-Smith talks about how an operation using new technology changed his life and could help reduce waiting lists.
Surgeons have done a double-lung transplant using a new machine that keeps donor lungs alive and breathing outside the body. This was the first time the machine was used in the UK.
The special device is like a bubble-shaped chamber with pumps and filters that repair and refresh the lungs before they are transplanted into patients.
The machine helps doctors check the lungs and fix them if needed before transplanting them. It also gives doctors more time compared to the old method of storing lungs on ice, which can damage the tissue.
Experts say this machine could greatly increase the number of lungs available for transplant in the UK, possibly saving hundreds of lives every year. Daniel Evans-Smith, 49, was the first UK patient to benefit from the XPS system, made by Xvivo.
Before his surgery at Royal Papworth Hospital in Cambridge, Evans-Smith, an events manager, had chronic obstructive pulmonary disease (COPD). This condition makes it hard to breathe and gets worse over time, limiting daily activities and sometimes requiring oxygen.
After receiving new lungs from a donor, which were kept alive using the XPS system, he woke up and found he no longer had COPD. “It’s amazing,” he said in an interview with the Guardian. “The difference is incredible.”
For over fifty years, doctors have preserved lungs for transplants by cooling them just above freezing, which slows down their processes and gives doctors a short time to use them. However, once the lungs are cooled, it’s hard to tell how good they are. Since lung transplants are complicated and life-changing, surgeons often avoid using organs that may not be in good condition. Because of this, only one in five donated lungs worldwide is used.
The XPS system helps doctors examine lungs longer, which means fewer organs will go unused and more patients can get a transplant. Evans-Smith only had to wait nine days for his transplant.
The Royal Papworth team that performed the first surgery with the XPS system in the UK used a technique called ex-vivo lung perfusion (EVLP).
EVLP is a technique used a lot in Europe and the US, but it hasn’t been common in the UK. In the UK, only a few EVLP transplants have been done, mostly as part of clinical trials or using different machines.
After their success with Evans-Smith, surgeons did transplants on three more patients using the XPS system.
This machine creates conditions like the human body, making the lungs expand and contract as they should. A special fluid helps keep the lungs in good condition and even improves their function. The lungs can be kept this way for up to six hours.
If the lungs work well during at least three hours of testing, they are taken out of the machine and prepared for transplant.
Evans-Smith’s surgery was done by a team led by surgeons Marius Berman, Giuseppe Aresu, and Pradeep Kaul. After recovery in critical care and the surgical ward, he recently went back home to Northampton to continue recovering.
Berman, the head of surgery for transplantation at Royal Papworth, said: “We are proud to be the first hospital in the UK to use this machine for lung treatment, which helped find the right donor lungs for Daniel. Without this technology, he might still be waiting for a transplant.”
Jasvir Parmar, chair of a national NHS lung advisory group, said the machine is a big step forward in doctors’ ability to check and improve the quality of donated lungs.
“Once the lungs are outside the body, we can improve how well they work. This is not just for checking the lungs but also for helping them perform better.”
Prof Derek Manas, from NHS Blood and Transplant, said the machine could help reduce the number of people waiting for organ donations.
“Right now, over 200 people are waiting for a lung transplant, but there aren’t enough donor organs. We must support new ideas to give hope to these patients who need a transplant.”
“We are thankful for the advancements in transplant technology and techniques, but most of all, we are thankful to the patients and families who donate organs to save and improve lives.”
Evans-Smith, who had a lung transplant, is excited to keep getting better over Christmas without the struggle of COPD. “Before the transplant, I couldn’t walk uphill or long distances without needing to stop and catch my breath. Now, I can do 7,000 steps a day, including hills, and I can walk 3,000 steps without needing to stop for a breath. It’s amazing!”
Published: 23th December 2024
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