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Biological Fluke Breathes New Life into Lung Transplants

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CHAPEL HILL, N.C. -- More than 300,000 Americans die of lung disease each year, making it the nation's third-leading killer. Lung transplants could reduce the number of deaths, but there aren't nearly enough donated lungs available.

Now, however, there's new hope for the people who desperately need lung transplants, based on a biological fluke.

Breath of Life

Our lungs actually live for hours after we die, while the rest of our organs deteriorate within minutes after our blood stops circulating. This means more people could end up like David Russell.

The North Carolina native beat the odds, becoming one of only about 1,600 people nationwide to receive a new set of lungs. Only about 15 percent of donated lungs are healthy enough for transplant.

"It was such a great thing to be able to breathe again!" Russell exclaimed. "Oh, you just don't know how much you appreciate breathing until you don't have it any more. Oh, it was great!"

The shortage of available lungs meant Russell would likely die while waiting for them. He prayed.

"I said, 'Lord, what I want to do is stay. I want to be with my family. I'd like to see some grandchildren,'" Russell recalled. "'But if You want to take me, that's perfectly fine. It doesn't matter. My life's in Your hands and it's all up to You.'"

The Finicky Lung

Most human organs for transplants come from hospital patients who are brain-dead and on life support. This works well for most organs, like hearts and livers, but lungs are usually too damaged to be transplanted as a result of prolonged hospital stays.

Dr. Benjamin Haithcock, a cardiothoracic surgeon at the University of North Carolina Hospital at Chapel Hill, performs lung transplants. He is currently involved in a study headed by Dr. Thomas Egan, also a cardiothoracic surgeon at UNC, investigating a new source of donated lungs.

"Lungs are very finicky when it comes to evaluating them for transplant," Haithcock explained. "One thing that we have to worry about with lungs is there are not enough. There are not enough organs out there for people who actually need them."

He said lungs from people who have been on life support are too often infected with pneumonia.

"At the time of their brain death they may have vomited or aspirated," he said.

Egan said the typical source of donated lungs is from people who die suddenly, such as from a heart attack in their homes, or in the emergency room. In other words, people who are not brain-dead and on life support for days.

"Individuals who die suddenly, which, this is a really tragic event, and obviously very upsetting for next of kin -- those lungs were perfectly normal up until the time of sudden death," Egan said. "They weren't subjected to the inflammatory processes of brain death."

Resuscitating and Recovering

Harvesting lungs from donors who die suddenly is possible because, unlike other organs that die within minutes of being deprived of oxygen from the blood, lungs have an oxygen reserve due to the air left inside them.

"They live for hours after death," he explained. "And lungs can be recovered and safely transplanted even if they are recovered after sudden death."

Wake County Emergency Medical Services, located near UNC hospital, is participating in Egan's research. They help recover lungs from people who die on one of their calls, and whose family consents.

Mike Bachman, deputy director and chief of Clinical Affairs, said while their rate of resuscitation is high, there are occasions where those attempts fail, at which time they notify Carolina Donor Services, who contact next-of-kin to discuss donating the victim's lungs.

"We don't want to miss the opportunity to ensure that the family realizes that our first goal was to make sure that they were resuscitated," Bachman explained. "So we don't want to blur those lines."

Bachman says once the family consents, EMS workers blow air into the lungs and transport the body to UNC hospital, where the lungs are then moved to Egan's lab.

In addition to lungs recovered from people who die suddenly at home, patients who die in the UNC hospital emergency room are also a part of Egan's research. Like the home fatalities, those lungs are harvested only after the family consents.

Preserving Life

After the lungs are removed from donor's body, they are delivered to Egan's lab. It is there that he and his team of researchers use what's known as ex vivo lung perfusion to preserve the lungs and check their viability for transplantation.

The procedure involves infusing the lungs with a special fluid that mimics blood flow into the lungs.

"Ex vivo lung perfusion affords an opportunity not only to evaluate lungs, but in the future, once we start transplanting lungs from this new donor source, we're going to be able to use ex vivo lung perfusion as a platform to treat lungs and potentially make them better," Egan explained.

He said that means more lives saved than ever before.

"Down the road, it's quite possible that this new donor source, in addition to being much more plentiful than brain-dead organ donors, the lungs from these new donors might turn out to be better than the lungs we're currently transplanting," he said.

If that comes to pass, there will be more people like David Russell, who will once again experience the joy of breathing freely and looking forward to a long life.

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About The Author

Lorie Johnson
Lorie
Johnson

As CBN’s Senior Medical Reporter, Lorie Johnson reports on the latest information about medicine and wellness. Her goal is to provide information that will inspire people to make healthy choices. She joined CBN in 2008 and has interviewed some of the world's leading doctors and researchers from The Mayo Clinic, Cleveland Clinic, Johns Hopkins, Duke, and more. She kept viewers up to date throughout the COVID-19 pandemic with regular appearances onThe 700 Club, Faith Nation, and Newswatch. She has reported on many ground-breaking medical advancements, including the four-part series, Build a