Surgeons at Royal Papworth Hospital in Cambridge have achieved a groundbreaking milestone in organ transplantation by successfully performing the UK’s first double-lung transplant using an innovative machine designed to revive and maintain donor organs outside the human body. This pioneering procedure utilized the XPS system, which is capable of reconditioning lungs, allowing them to breathe and function as they would inside the body before being transplanted.
The XPS device, resembling a bubble-like chamber filled with pumps and filters, provides a vital service by perfusing the lungs with a special fluid that not only assesses their quality but also enhances their performance. This advancement significantly extends the preservation time for donor lungs compared to traditional methods, which involve cooling the organs on ice—a process that can lead to tissue damage and limits evaluation opportunities.
This revolutionary approach could dramatically increase the number of lungs available for transplant within the NHS, potentially saving hundreds of lives each year. Daniel Evans-Smith, a 49-year-old events manager and the first patient to benefit from this technology in the UK, expressed his gratitude for the procedure, stating, “The difference is phenomenal,” after waking up free from chronic obstructive pulmonary disease (COPD).
For over fifty years, lung preservation has relied on cooling techniques that slow down metabolic processes but do not allow for thorough quality assessments. As a result, only about 20% of donated lungs are utilized globally. The XPS system changes this dynamic by providing surgeons with more time to evaluate and rehabilitate organs, ensuring that fewer donor lungs go to waste. Evans-Smith was on the waiting list for just nine days before receiving his transplant.
The surgical team led by consultants Marius Berman, Giuseppe Aresu, and Pradeep Kaul successfully employed ex-vivo lung perfusion (EVLP), a technique that has gained traction in Europe and the US but has been less common in the UK. Following Evans-Smith’s surgery, three additional patients have also received transplants using this advanced system.
Berman remarked on the significance of this achievement: “We are very proud to have become the first UK hospital to use this machine for a clinical ex-vivo lung perfusion case.” Jasvir Parmar, chair of a national NHS lungs advisory group, emphasized that this technology represents a significant shift in how doctors can evaluate and enhance donated lungs.
With over 200 individuals currently awaiting lung transplants in the UK, Prof. Derek Manas from NHS Blood and Transplant highlighted the importance of such innovations in addressing organ shortages. He stated that supporting advancements in transplantation technology is essential for improving outcomes for patients with life-threatening conditions.
Evans-Smith is now looking forward to enjoying life without the limitations imposed by COPD. He shared his excitement about his newfound abilities: “Now I might be doing 7,000 steps a day, including going up and down hills… It’s just amazing!”
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