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Friday, 16 March, 2001, 00:28 GMT
Lung transplant breakthrough
Organs can be preserved after death
Scientists have found a way to increase the number of lungs available for transplant surgery.

Donor organs are in short supply in general in the UK, but the shortage of lungs is particularly severe.

This is because up to 80% of potential donor organs have to be discarded because they do not work well enough.

As a result, as many as 40% of people with cystic fibrosis die while waiting for a transplant.

Until now lungs, in common with many other organs, are only removed from donors while their heart is still beating.

This has huge potential to free up organs that would make a tremendous difference to an enormous amount of people

Mr Martin Elliott, Great Ormond Street Hospital
This is because the organs deteriorate rapidly once they do not receive a regular supply of oxygen, and doctors have no method of measuring how well they are functioning once the patient has died.

But Swedish doctors have successfully used lungs taken from a donor hours after their heart had stopped beating.

The donor was a patient who died of a heart attack in a cardiac intensive care unit after failed resuscitation.

Cooling down

The organs were preserved by cooling down the dead person's body using a salt solution.

Doctors gained permission from the next of kin before starting the cooling process an hour after death.

The next of kin was given time with the body while it was cooled.

After two hours, the lungs were removed and a mixture of blood and a preservation fluid was pumped through them for the next eight hours.

Not only did this keep the lungs healthy, it also enabled doctors for the first time to assess whether they were still in working order.

Eventually, the right lung was successfully transplanted into a 54-year-old woman with chronic obstructive lung disease.

The donor lung began to work very well shortly after transplantation, and remained effective five months after surgery.

Researchers from University Hospital, Lund, carried out the procedure after discussions with doctors, nurses, hospital chaplains and judges.

Lead researcher Dr Stig Steen said the lung function of non-smokers was usually good, even in old age.

He said: "Most patients in Sweden who need new lungs have chronic obstructive pulmonary disease and are 60 years of age or older.

"When all hospitals and ambulance personnel in Sweden have received training in non-heart-beating lung donation, we hope that there will be enough donor lungs of good quality for all patients who could benefit from a lung transplant".

Ethical concerns

Professor John Dark, head of the heart and lung transplant unit at the Freeman Hospital, Newcastle Upon Tyne, told BBC News Online that the solution used by the Swedish team to preserve the lung had probably also helped to improve its function.

However, he said that to carry out the procedure on a wide scale would present logistical problems, not least that work would have to be started on the dead person's body before permission to use the organs had been sought from relatives.

But he said: "It might be possible to increase the number of lung transplants carried out in this country by 20-25%.

"There would also be other benefits to being able to preserve lungs for a longer time. For instance it would mean that transplant surgery could take place in daylight hours."

Mr Martin Elliott, head of cardiothoracic transplantation at Great Ormond Street Hospital for Sick Children in London, said a mature public debate was needed on the future of transplantation.

He told BBC News Online: "This has huge potential to free up organs that would make a tremendous difference to an enormous amount of people.

"But first we need a rational debate, and to build a relationship of trust with the public.

"By involving the people who do transplants in a public debate we could agree the best way forward without these people being seen as something out of Burke and Hare."

The research is published in The Lancet medical journal.

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See also:

27 Feb 01 | Health
Drive for new organ donors
03 Feb 01 | Health
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