Ex Vivo Lung Procedure is a kind of therapy that is beneficial to people who are suffering from end-stage lung disease leading up to lung failure. For such people, lung transplant is the only solution. However, cadaver donor lungs are always less in number than the people on a transplant waiting list. On top of that, it is difficult for physicians to assess the suitability of donor lungs for transplant as the lungs may have been damaged at the time of harvesting. So, Ex Vivo Lung Procedure is a therapy in which donor lungs are treated outside the body in a machine, and operated as if they were inside the body and carefully evaluated. Post evaluation, they are transplanted into the recipient. In this article, we will learn more.
The lungs are vulnerable to a range of conditions, and one of them is lung failure. This is a progressive condition in which the lung function is failing gradually and will culminate in total failure one day. This is fatal to the person. Lung transplantation is the only treatment option for such persons. This will require lungs to be harvested from cadaver donors (dead individuals whose families are willing to donate the lungs) and implanted in the body. The prospective recipients are listed on a waitlist and will get the lungs as per their turn. Till such time the actual transplant happens, the donated lungs will be kept in a freezer, at sub-zero temperatures. They will be thawed just before transplant.
However, the process is not easy as it sounds. The dead person may have suffered brain death and may have been in ICU for a certain duration of time. Both these situations can cause some damage to the cadaver lungs at the time of harvesting. The extent of damage can vary. In some cases, the lungs may not be usable at all. While in some cases, the lungs are partially damaged, in which case, they cannot be transplanted right-away. Both these situations reduce the percentage of donated lungs that can be used for transplantation. This is an unfortunate outcome for both the donor’s family and the recipient on the waiting list. In many cases, it even results in the demise of the waitlisted person.
So since the 2000s, and more so since 2011, a procedure called Ex Vivo Lung Perfusion (EVLP) emerged and evolved as the perfect solution in such a scenario.
Ex Vivo Lung Perfusion (EVLP) is a unique therapy that is performed on cadaver donor lungs outside of the body and before transplant in the recipient’s body. This therapy improves the quality of the lungs and makes even those lungs that were previously unsuitable, safe for transplant now. This way, it expands or enlarges the donated lung pool for potential recipients of lung transplant.
EVLP was developed in the 2010s decade to address the issues of donated-lung wastages. Prior to EVLP, the donated lungs with whatever damage they possessed were kept in cold storage. When the transplant recipient was ready, the lungs were retrieved from cold storage, but many were not found to be suitable for transplant. So, EVLP takes a different approach.
In this case, the donor lungs are kept in a special machine at normal temperatures of 37 degrees Celsius. They are supplied with oxygen and other nutrients which helps them sustain, aerobic and active, cellular metabolism outside the body. This keeps them functioning as if they were inside a human body, for more than 12 hours. In the process, the lung function can be properly assessed. At the same time, the damage to the lungs is treated and healed. This is a boon to the lung-transplant recipient community, as it helps maximize the number of donor lungs that can be transplanted into waitlisted recipients.
To summarize, the EVLP is not just a therapy but a platform that helps:
The donated lungs are placed inside a sterile dome that is made of plastic fibre. The dome is attached to a ventilator, a pump and some filters. The temperature inside the sterile dome is maintained at normal body temperature of 37 degrees Celsius. The lungs are treated with a bloodless solution (called perfusate) that contains oxygen, proteins and nutrients. The solution helps reverse any injury in the lungs while also removing excess water from the lungs.
So, a typical EVLP circuit consists of
The EVLP process is highly technical is nature and describing it would require the use of highly techno-medical terminology, most of which are beyond the comprehension of people outside the medical community. That is why, we are giving a brief summary of each step after simplifying it as much as possible.
If you or a loved one need expert care for lung disease leading to transplantation, look no further. The specialists at Kauvery Hospital, with branches across key cities like Chennai, Hosur, Salem, Tirunelveli, and Trichy, are highly skilled in innovative treatments like Ex Vivo Lung Perfusion therapy. Trust us to provide quality and compassionate care every step of your healthcare journey.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
Chennai Alwarpet – 044 4000 6000 • Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801
