Artist rendering of the new lung transplant center at Mayo Clinic in Florida. (Handout)
The Mayo Clinic in Jacksonville, Florida will soon be home to a new lung restoration center, which physicians expect will help them effectively refurbish donated lungs for use in transplants.
The center will utilize a burgeoning technology called ex vivo lung perfusion, in which damaged tissue in donor lungs is restored through a cocktail of specialized solutions and gases. The process also can remove excess fluid in the lung, making it clinically viable for transplant.
Mayo has not shared info on costs for the new center, which is slated for completion in late 2017 However, Dr. Cesar Keller, the assigned medical director for the project, said it will be funded primarily through a series of grants and should ultimately save the Mayo Clinic money. Often, when a transplantable lung comes along, the patient is already on a ventilator and requires intensive postoperative care -- an expensive way to take care of patients.
This will be othe second such center in the country with this lung restoration capability, he said. The other is in Silver Spring, Maryland.
"Currently, there's a multicenter national trial where these lungs have been processed," said Keller. "Whenever one of our recipients needs lungs like that, we fly them to Silver Spring, and we bring them back here and transplant them."
Having lung restoration capabilities on-site, he said, would eliminate the need to send patients to other centers, or to procure lungs that have been rehabilitated elsewhere.
By inserting a tube into the trachea of a marginal set of lungs, physicians can inflate and deflate them, and in the process run a high-protein solution through them instead of blood. The solution sucks adema out of the lung tissue, at which point the organ is placed in a specialized chamber that protects it and keeps it at body temperature. Antibodies or other agents can then be used to further heal it; areas that are collapsed can be expanded.
"After a few hours, if the lung is showing resolution of whatever the injury was .... then those lungs could still be inserted into the recipient," said Keller. "So the idea is that this technology is recapturing lungs that in the past would have been discarded."
As part of the agreement, Mayo Clinic will lease land on its campus to a subsidiary of United Therapeutics, a biotechnology company, to construct, equip and operate the center. The Mayo Clinic will provide physician oversight, as well as secure and deliver lungs to the center for restoration.
"This collaboration is exciting," said Dr. Gianrico Farrugia, CEO of the Mayo Clinic's Jacksonville campus. "It allows Mayo Clinic to bring the latest advances in life-saving technology to transplant patients. … Increasing the number of lungs available for transplantation provides more options for patients suffering from pulmonary disease."
According to the U.S. Department of Health and Human Services, about 123,000 people in the United States are waiting for an organ transplant. About 1,600 people are waiting for a lung transplant. Every 10 minutes, another name is added to the national waiting list at the United Network for Organ Sharing, the organization that manages the country's organ transplant system.
On average, about 18 people die each day waiting for transplants that can't occur because of the shortage of donated organs.
That, said Dr. Martine Rothblatt, chairman and co-CEO of United Therapeutics, is what makes the new center so important.
"Only about 1 percent of people who sign organ donor cards die in a way that renders their organs transplantable," she said, "and most of those precious few lungs are currently discarded due to their rapid deterioration upon death. We are confident that our ex-vivo lung perfusion technology will enable many of these otherwise discarded lungs to instead be used as gifts of life to patients on the lung transplant waiting list."
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The Mayo Clinic has transplant practices spread across campuses in Florida, Arizona and Minnesota. The three campuses combined employ about 200 physicians trained in transplant medicine and surgery, and perform about 1,800 transplants a year. Since 2001, the Jacksonville clinic has performed 469 lung transplants and eight heart-lung transplants.
Keller said the impact of the new center to patients should be remarkable.
"Right now, they cannot get a donor immediately, so they linger on the waiting list and they deteriorate," he said. "There is always a percentage of them that will die before they can be transplanted, because there are just not enough lungs for everybody. If the lung (availability) increased by two or three times, it should wipe out the waiting list. Nobody should die waiting."