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 The XPS, manufactured by Swedish company XVIVO Perfusion, is in
clinical trials at 16 U.S. medical centers. Known as "the box," it
ventilates the lungs after removal from the donor and infuses them
with a fluid mix of drugs and steroids, effectively drying them out
and getting them in better shape for use in a transplant operation.
The technology, which has not been used widely before, aims to
increase the donor pool by reconditioning marginal lungs not
suitable for transplant.
"It allows the lungs to stay alive ... and allows us as providers to
assess the function of the organ in a unique, well-controlled
environment,” said Dr. Varun Puri, an associate professor of
cardiothoracic surgery at Washington University in St. Louis.
The XPS, which is under test at Washington University, Duke
University Medical Center, New York-Presbyterian Hospital and more
than a dozen other U.S. sites, has been cleared for use in Europe
and Canada and was approved for clinical trials by the U.S. Food and
Drug Administration as a Humanitarian Use Device.
Michele Coleman, 63, credits 'the box' with saving her life. A
former smoker, she was diagnosed with chronic obstructive pulmonary
disease, a lung ailment with no cure.
“You don’t want to, but you kind of lose hope because when you are
sick like that you know how fast you are going downhill," Coleman
said.
Last year, Coleman’s doctors asked if she wanted to participate in a
clinical trial, explaining that she would receive donor lungs that
needed to take an out-of-body detour for reconditioning before her
transplant.
"It’s scary, but anything that they could give me was going to be
better than I had, and actually I figured I wouldn’t make it to the
end of the year,” she said.
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The machine is made up of a ventilator to simulate breathing and a
bypass machine to perfuse the organs with a drug-laden solution
aimed at improving their function. It mimics the human body, but
with one major difference.
“The lungs in the body are performing a function, they are providing
oxygen to the body and they are removing carbon dioxide, they are
performing gas exchange, thus there is some degree of stress on the
lungs," said Puri. "When they are in the box or on the circuit,
there is really no function they are expected to perform.” That
gives them time to heal, he said.
The statistics for lung transplants make grim reading. Fewer than 20
percent of donor lungs are considered suitable for transplant and up
to 25 percent of candidates die waiting for a transplant. Even after
receiving donor lungs, just over half survive five years.
The device addresses the first two statistics by potentially
increasing the donor pool. Doctors say that with further research it
could help increase survival rates as well.
(Reporting by Ben Gruber; Editing by Bill Rigby)
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