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Transplants
From Beating Hearts to
Breathing Lungs:
New Technologies Increase Use of Donor Organs
More than 1,600 people in the United States are
currently awaiting a lung transplant, yet more than
70 percent of available donor lungs will ultimately be
discarded because of poor organ quality or distance
between the donor and recipient. An experimental
organ-preservation device may help to increase the
utilization of available organs by keeping donor
lungs functioning in a near-physiologic “breathing”
state while being transported for transplantation.
organs. This technology enables us to maintain the
organ in better shape before transplant.”
The key principles that mark OCS as a powerful
and potentially revolutionary technology in lung
transplantation build upon those developed and
evaluated earlier in the “beating heart” clinical
trial conducted at UCLA and four other leading
heart-transplant centers in the U.S. As principal
investigator, Dr. Ardehali helped to improve
the safety and effectiveness of OCS in heart
transplantation by refining functional and
metabolic testing to enable more comprehensive
organ assessment.
“Lungs are very sensitive and can easily be
damaged during the donation process,” explains
cardiothoracic surgeon Abbas Ardehali, MD,
surgical director of the UCLA Lung and Heart and
Lung Transplant Program.
“This new ‘breathing lung’
technology enables us to
“Human organs were never
potentially transport lungs
over longer distances, which
meant to be put on ice in a
will expand our donor pool,
cooler. … This technology
as well as improve the
function of donor organs
enables us to maintain
before they are placed in
the organ in better shape
the recipient.”
before transplant.”
In November 2012, the
lung-transplant team at
Ronald Reagan UCLA
Medical Center successfully performed the
nation’s first “breathing lung” transplant, using the
experimental organ-preservation device known
as the Organ Care System (OCS). OCS simulates
the conditions of the human body and allows
the lung to continue functioning normally in a
warm, breathing state, continually perfused with
oxygenated, nutrient-rich blood. It also enables
surgeons to assess lung function, clean the airways,
infuse medications and even repair the lung
before transplantation.
The current standard of care, cold ischemic storage,
involves transporting the donor lung in a non-
functioning, non-breathing state inside an icebox.
“Human organs were never meant to be put on ice in
a cooler,” Dr. Ardehali explains. “Too many patients
die because we have a shortage of suitable donor
“Before, we used crude
parameters to assess donor
hearts,” Dr. Ardehali says.
“Over the past few years,
we have developed better
mechanisms to evaluate
how well the heart is
being preserved, and this
knowledge is being used
around the world.”
The Organ Care System simulates the
conditions of the human body and allows
donor lungs to continue functioning
normally in a near-physiologic
“breathing” state outside of the body.
OCS also has the potential
to reduce the risk of organ
rejection and increase the number of hearts accepted
for transplant. Eventually, Dr. Ardehali says, it may
even be possible to “warehouse” functioning organs
for longer periods in order to facilitate better donor-
recipient matches and allow time to modify some of
the donor organs that would otherwise be rejected.
But not all patients will receive or accept a
human heart or lung. As a high-volume organ
transplant center, UCLA has also contributed to
the advancement of artificial devices, such as left-
ventricular-assist devices, which are used to partially
or completely replace the function of a failing heart
for patients who are awaiting transplants or to
provide emergency support to patients with failing
hearts caused by severe episodes of rejection. To
date, more than 200 artificial devices have been
implanted at UCLA.
3 UCLA Physicians Update