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Dr. Pasquale Ferraro, chief of thoracic surgery at the CHUM, uses a pig’s lung to show off a new device that allows blood and oxygen to circulate within a lung after it has been removed from a donor. The procedure, called ex vivo perfusion, allows doctors to better evaluate the lung before deciding whether it is suitable to be transplanted. The CHUM expects to use the machine for the first time next month.

Photograph by: CHUM , The Gazette

MONTREAL – As the director-general of Quebec’s organ donation program, Louis Beaulieu knows how stressful it can be for sick patients who are awaiting an organ transplant.

“They worry about dying and seeing their health decline,” Beaulieu said on Monday at a news conference at the CHUM, where surgeons unveiled a new device that they say will lead to more lung transplants and improve the quality of lungs being transplanted.

The CHUM has purchased two machines that allow blood and oxygen to circulate within a lung after it has been removed from a patient — rather than simply keeping the lung on ice prior to the transplant.

The procedure, called Ex vivo perfusion, allows transplant surgeons to better evaluate the quality of a lung before proceeding with a transplant, said Dr. Pasquale Ferraro, the head of thoracic surgery at the CHUM.

Only about 25 per cent of donated lungs are in good enough shape to be transplanted. Another 25 per cent are borderline, so the new device will help surgeons determine whether those lungs are healthy enough to be given to patients.

“Donated lungs that would otherwise be excluded or judged inadequate can now be processed and transplanted,” Ferraro said.

“If the lungs are not good or infected, they are turned down.”

When a donated lung arrives at Notre-Dame Hospital, it will be placed in a basin that resembles an incubator. A pump will perfuse blood and oxygen through the lung, keeping it as healthy as possible before the transplant.

The CHUM expects to use the machine for the first time next month. The device will allow for more transplants of better quality lungs and reduce the wait times for patients needing a transplant, doctors say.

“Our ultimate goal is to increase the number of organs available so no patient on the waiting list dies before having a transplant,” Ferraro said.

He hopes the device will allow surgeons to do 10 to 12 additional lung transplants a year.

In 2013, 52 lung transplants were done at Notre-Dame, where the province’s only lung transplant program is situated.

At present, about 95 to 100 patients are on the waiting list. Between 15 and 20 per cent of patients die before they get a transplant. About 30 per cent of patients needing a lung transplant suffer from cystic fibrosis.

“The number of people needing transplants is increasing and the number of organs is insufficient,” Ferraro said.

There have been 477 lung transplants in Quebec since 1997.

A second machine will be used to further study the technology at the CHUM’s research centre. The system was developed in Sweden and the two machines were purchased for about $400,000.

Although hospitals in Toronto and Edmonton use a similar technology, the device the CHUM has purchased is the first of its kind in North America. About 10 hospitals in Europe use the technology. It is not yet available in the U.S.

“For once, we can say: ‘We had it before the Americans,’ ” Ferraro joked.

SOURCE:

http://www.montrealgazette.com/health/CHUM+gets+groundbreaking+machines+help+with+lung+transplants/9545949/story.html