The UK's first double lung transplant using “lungs in a box” was successful

Patient, 49, Daniel Evans Smith, received the procedure at the Royal Pupworth Hospital NHS Foundation Trust in Cambridge, UK. This technique is called ex-bivo pulmonary perfusion (EVLP). This involves taking donated lungs that may be classified as slightly accepted/unacceptable, reconditioning them outside the body, and preparing for a donation.

“I feel very privileged to be offered the opportunity to be in this situation,” Evan Smith explained a few months after the procedure. statement. “Last year, there was a discussion that I might need palliative care soon. Without a lung transplant, I could not survive too long.”

What is EVLP?

EVLP is an innovative treatment that is widely used in the US and Europe, but is not common in the UK. This procedure is an important breakthrough in the improvement of lung transplants in the UK, and Royal Paps is currently the only UK centre using EVLP in clinical cases. In some previous cases, it was used in clinical trials or other machines. .

Once removed from the donor, the lungs are placed in ice. When they arrive at the recipient's hospital, they are attached to the machine. They penetrate and ventilate donor organs, inflate their lungs and mimic the human body.

Special fluids are used to maintain the lungs and to help restore normal function. This can help maintain and improve the donor's lungs. The lungs can be maintained for up to 4 hours, with the necessary short-term therapeutic agents available to complete a detailed assessment. If the lungs function normally for 3 hours, they are placed on ice for implantation.

“The rapidly changing landscape of organ donation in the UK has led to significant changes in the ability to assess donor lungs. Ex vivo pulmonary perfusion (EVLP) causes clinicians to deliver high-quality organs to patients on the waiting list. “We can ensure that we are committed to the company,” explained Dr. Jas Parmar, a port consultant at Royal Papworth.

A groundbreaking case

Evans Smith had developed chronic obstructive pulmonary disease (COPD), a condition that caused difficulty in breathing and restricted normal activity. He experienced five lung collapses between the second half of 2023 and early 2024.

He was placed on the lung transplant list in the summer. And while he was still in the hospital and ready to be discharged, he was awakened to the nurse who gave him the news that the appropriate donor's lungs had been identified.

His implant surgery was successful and upon completion of the implant, Evans Smith was rehabilitated, after which he returned home to recover.

“The transplant has already made a huge difference. Evans Smith said I have not had the cold, chest infection or symptoms that I have suffered in the past few years. “I have already made a big difference. You can walk ahead too. You can climb the hill without thinking about it. I don't need to rest that often.”

In the UK, there are many people on the waiting list for lung transplants. This exceeds the number of appropriate donor organs. Such new technologies could improve opportunities for these patients.