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'Lung In A Box' Keeps Organs Breathing Before Transplants

When doctors rush a lung to a hospital for a transplant, the precious cargo arrives in the operating room in a container that seems more appropriate for Bud Light — a cooler filled with ice.

That's been the protocol for donated organs for decades. Doctors drop them into a plastic bag and put them on ice. But lungs soon stop breathing. Hearts stop beating. The organs essentially shut down and start to deteriorate.

This means doctors have only about five to 10 hours to get the lung from the donor into the recipient. If the travel time is too long, the organ can't be used and goes to waste.

Now a team of doctors and engineers in Massachusetts is trying to change that.

The company TransMedics in Andover has developed an experimental device that keeps hearts and lungs alive while they're transported from the donor to the recipient.

It's essentially a "lung in a box," says transplant surgeon Abbas Ardehali in a video for the University of California, Los Angeles.

Known as the Organ Care System, the device circulates blood through the lungs and pumps oxygen through the lobes. So the lungs can breathe outside the body.

The machine isn't yet approved by the Food and Drug Administration for use in the U.S. But eight hospitals around the country are it out in a clinical trial.

TransMedics is also developing a similar machine for hearts. It keeps a heart warm, pumps blood through it and feeds it nutrients, so the heart continues to beat outside the body.

And both devices are portable. So they can hop on the medic helicopter along with the transplant crew.

"For the first time, the donor lungs can be maintained in a breathing, warm, nourished state during transport," Ardehali says.

In a preliminary study, the lung in a box successfully worked in 12 transplants. Now doctors in the U.S., Canada and Europe are performing a larger study with more than 250 patients to see whether the machine can outperform the ice-and-cooler mode of transportation.

The hope is that the lung in a box and its heart equivalent will one day increase the success rates of transplants, Ardehali says, by extending the life of an organ outside the body. Then doctors could spend more time finding a perfect match for the lung or heart. And the organs could be transported farther distances.

"On an annual basis, more than 30 or 40 hearts in Hawaii go unused," Ardehali says. "Because of the distance, these hearts cannot be transported to the mainland."

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.