A 49-year-old man in the United Kingdom has become the first patient to successfully receive a double-lung transplant using a machine nicknamed “lungs in a box.”
The record-breaking transplant, which relied on a new-generation lung transplant machine (XPSTM), was conducted by doctors at Royal Papworth Hospital NHS Foundation Trust in Cambridge, UK.
The XPSTM system from XVIVO, which uses a technique called ex-vivo lung perfusion (EVLP) to recondition donor organs, could significantly increase the number of viable donor lungs, offering new hope to those awaiting life-saving transplants.
Daniel Evans-Smith underwent the procedure at the Royal Papworth Hospital NHS Foundation Trust in Cambridge, which uses EVLP to recondition donated lungs outside the body, making even marginally acceptable or unacceptable organs suitable for transplant.
In a statement released by the hospital last week, months after the procedure, Evans-Smith said he would likely not have survived for longer if it were not for the successful lung transplant since he had been prescribed palliative care.
Significant Advancement in Lung Transplantation
EVLP, widely used in the United States and Europe but less common in the UK, is a significant advancement in lung transplantation. Royal Papworth is currently the only UK center using EVLP for clinical cases; it had previously been used in clinical trials or with other machines.
The process involves placing donor lungs, initially stored on ice after removal, into the XPSTM machine upon arrival at the recipient’s hospital. The machine perfuses and ventilates the organs, mimicking the human body by inflating and deflating the lungs.
A special fluid maintains the lungs and helps restore normal function, allowing for up to four hours of maintenance, including administering short-term therapeutics and conducting detailed evaluations. Lungs performing successfully for over three hours are then placed on ice for transplantation.
High-quality Organs for Transplant
Dr Jas Parmar, a transplant consultant at Royal Papworth, said the EVLP technique allows clinicians to deliver high-quality organs to patients eagerly waiting for the life-saving organ transplant.
Evans-Smith suffered from chronic obstructive pulmonary disease (COPD), a condition causing breathing difficulties and limiting normal activity. He experienced five lung collapses in late 2023 and early 2024.
Placed on the transplant list in the summer, he was notified while hospitalized that suitable donor lungs had been found. Following a successful transplant, Evans-Smith underwent rehabilitation and has since returned home.
With the UK facing a shortage of suitable donor lungs, with the number of patients on the waiting list exceeding available organs, Technologies like EVLP offer hope for improving transplant outcomes and increasing the availability of life-saving organs.
