The hope technique shows promise for long-term donor lung preservation

The hope technique shows promise for long-term donor lung preservation

A study of donor lungs preserved outside the body before transplantationPresentEven if the total non-physical times approach 20 hours.

Jitte Jennekens, MSC, organ perfusionist/transplant coordinator at UMC Utrecht in the Netherlands, presented the study results at today's International Society for Heart and Lung Transplantation (ISHLT) Annual Meeting and Scientific Sessions in Boston.

“This technique is used to preserve donor livers and kidneys and is being studied in clinical trials for hearts, but it has not yet garnered as much attention for lung preservation,” Jennekens said.

Ex vivo Lung Perfusion (EVLP) is a technique that allows donor lungs to be maintained, evaluated, and potentially overhauled outside the body prior to transplantation. The lungs are connected to a pump and a ventilator and are perfused with a solution that acts as a physiological fluid.

UMC Utrecht developed its Hope protocol to safely extend perfusion times to maintain lung viability overnight until transplantation can be performed during the day.

Donor lungs selected for EVLP are typically transported on ice and then warmed to 37 degrees Celsius using a normothermic EVLP protocol (NEVLP) for functional evaluation. After NEVLP, the lungs are then returned to ice until transplantation begins.

The Hope protocol eliminates the second period on ice by evaluating the lungs during one hour of NEVLP and then maintaining the lungs at 12 degrees C until surgery.

Jennekens presented data comparing the outcomes of 12 cases treated with the NEVLP-Hope protocol with a historical cohort of donor lungs transplanted directly into patients, without ex vivo lung perfusion.

The control cohort included 118 cases of lungs transplanted directly without perfusion between 2017 and 2022. The cases were conducted between 2022 and 2024 using the Hope protocol for logistical reasons.

No lungs were rejected for transplantation in the NEVLP-Hope group, and short-term outcomes were similar between the study and control groups.

“Our results show that hope is a safe and effective method of lung preservation after a period of normothermic EVLP,” said Jennekens.

Jennekens said the next step is to determine the preservation strategy that is most beneficial for a particular type of donor lung.

“Extending perfusion times for donor lungs outside the body will enable a future in which donor lungs can be optimized with various therapies,” she said.

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