May 9, 2019

Rehab technique may boost supply of donor lungs

A new regeneration technique could potentionally add to a limited supply of donor organs for an increasing population with end-stage lung disease.


by Matt Batcheldor

About 80% of donor lungs are too damaged to be considered for transplantation, but a new technique could rehabilitate many of them to the point where they could be.

The new technique could potentionally add to a limited supply of donor organs for an increasing population with end-stage lung disease, according to research from Matthew Bacchetta, MD, MBA, MA, associate professor of Thoracic Surgery.

Bacchetta and colleagues from Columbia University studied a novel interventional platform using cross-circulation from an animal model. The method resulted in significantly improved lung function and cellular regeneration and allowed researchers to develop diagnostic tools for non-invasive organ evaluation and repair, according to the study published in Nature Communications.

“Our work has established a new benchmark in organ recovery,” Bacchetta said. “It has opened up new pathways for translational applications and basic science exploration. We have spent years refining this technology to improve the recovery and regeneration of organs.”

The study focused on lungs injured by gastric aspiration, or the introduction of material from the stomach to the lungs. Many lungs rejected for transplant have gastric aspiration or a similar type of injury, Bacchetta said.

Current methods of preserving lungs only give doctors about six hours to assess them, which is insufficient time to rehabilitate them, Bacchetta said. His team demonstrated that the cross-circulation technique could maintain lungs for 36 hours, giving doctors time to rehabilitate the lungs and test new interventions. The regenerated lungs met criteria for transplantation, something that wasn’t possible with existing methods.

As doctors refine the new technique, Bacchetta foresees expanding the time to work on organs to days or even weeks. That will allow much more time to not only rehabilitate organs, but explore new techniques of repairing them, including bioengineering solutions.

“We were driven not just by the clinical need but also by a basic science need of being able to create a system that provides durable physiologic support for the organ to regenerate,” he said.

Further study will be required to determine how well such rehabilitated lungs function, the safety of the method and how such lungs respond to immunosuppressive drugs that are given after transplantation. The study envisions that the method may also be studied for other damaged organs — such as hearts, kidneys and livers — to potentially expand the pools of those donated organs as well.

“Dr. Bacchetta and his colleagues achieved a critical advance that could increase the number of organs available for transplant and realize the goal that no patient dies waiting for an organ,” said Seth Karp, MD, H. William Scott Jr. Professor and chair of the Section of Surgical Sciences.