A large proportion of donated lungs cannot be used for transplants. Researchers from Lund University in Sweden and Skåne University Hospital have conducted an animal study that gives hope that more donor lungs may be used in the future. Researchers have launched a pilot study to determine if the treatment will have the same positive effects in humans.
About 190 organs are donated each year in Sweden. Due to lung damage, only 30% of them can be used for transplantation. In addition, the mortality rate is high: about half of patients die within five years of transplantation.
The results of our study indicate that a certain treatment can help us use more of a donor lung, and that there is an improvement in results during the first two days after surgery. »
Sandra Lindstedt, Senior Consultant in Thoracic Surgery at Skåne University Hospital and Assistant Professor at Lund University.
In their pig study, the researchers looked at the effects of reducing cytokine levels in the lungs. Cytokines are small proteins that are produced by specific cells of the immune system.
Lung function was reduced prior to transplantation such that the lungs developed acute respiratory distress syndrome (ARDS). In doing so, the lungs acquired lesions similar to those of the donor lungs in humans. In ten cases, the donor lung was treated – either before and after transplantation, or only after transplantation. Six cases constituted a control group and received no treatment.
“The results show that lung function was restored to a higher capacity than before due to the reduction in cytokine levels. We were also able to see that the lungs functioned better after the transplant and that complications during the 48 hours following the transplant were reduced,” says Sandra Lindstedt.
Around 50-60 lung transplants are performed each year at Skåne University Hospital in Lund and Sahlgrenska University Hospital in Gothenburg. The hope is that this number will increase with this new treatment.
“It won’t work on all donor lungs, but if we can use it on some of the donor lungs that are being rejected today, it could be of great significance to patients on the waiting list for a transplant. We hope to create the necessary preconditions to save more patients,” says Sandra Lindstedt.
To be able to conduct this study, a special unit was created within the Department of Cardiothoracic and Vascular Surgery, Anesthesia and Intensive Care at Scania University Hospital. The unit gathered all the necessary skills for the study.
“This study would not be possible without the great efforts of the various clinical specialties, such as thoracic surgeons, anesthesiologists, perfusionists, operating room nurses and anesthesia nurses. »
The results of the study, which are published in NatureCommunicationsare the basis of a recently launched clinical pilot study.
“We have started enrolling the first patients in the pilot study at Skåne University Hospital in Lund. The entire study involves 20 transplants, half of which will be treated to reduce cytokine levels, and the rest will be treated conventionally. If we obtain positive results, we will extend the study and include 120 transplants nationwide,” concludes Sandra Lindstedt.
Ghaidan, H. et al. (2022) Reduction of primary graft dysfunction through cytokine adsorption during organ preservation and after lung transplantation. NatureCommunications. doi.org/10.1038/s41467-022-31811-5.