A recent study has shown that donor lungs preserved outside the body using the hypothermic oxygenated machine perfusion (HOPE) technique remain safe and viable for transplantation, even with out-of-body times nearing 20 hours.
The findings were shared by Jitte Jennekens, MSc, an organ perfusionist and transplant coordinator at UMC Utrecht, Netherlands, during the Annual Meeting and Scientific Sessions of the International Society of Heart and Lung Transplantation (ISHLT) held today in Boston.
“While HOPE is already widely used for preserving donor livers and kidneys, and being tested for hearts, its application for lung preservation has been limited so far,” said Jennekens.
Ex vivo lung perfusion (EVLP) is a method that keeps donor lungs functional outside the body, allowing clinicians to evaluate and possibly improve the lungs before transplant. Lungs are attached to a pump and ventilator and are circulated with a solution mimicking physiological conditions.
At UMC Utrecht, the HOPE protocol was designed to extend perfusion times safely, preserving lungs overnight and making it easier to perform transplants during daytime hours.
Traditionally, lungs prepared for EVLP are transported on ice, then warmed to 37°C using a normothermic EVLP (nEVLP) protocol for evaluation, and again cooled on ice before transplantation.
The new HOPE approach eliminates the second chilling phase by initially assessing lungs with an hour of nEVLP, followed by preservation at 12°C until surgery.
Jennekens presented data from 12 transplants performed using the nEVLP-HOPE protocol, compared with a historical group of 118 patients whose lungs were transplanted directly without EVLP between 2017 and 2022.
Importantly, none of the lungs preserved using the HOPE method were rejected, and short-term outcomes were comparable between the two groups.
“Our results support that HOPE is a safe and effective way to preserve lungs following normothermic EVLP,” Jennekens noted.
She further explained that future work will focus on identifying the best preservation strategy tailored to different types of donor lungs.
“By extending the time donor lungs can be kept viable outside the body, we open the door to new therapies that can optimize lungs before they are transplanted,” she added.
