Engineers Revive Historic Medical Technique to Save Damaged Donor Lungs

Photographic, radiographic and thermographic images of injured lungs recovered with extracorporeal cross-circulation. Lungs subjected to this novel therapy demonstrated normal function: perfusion, ventilation and gas exchange - after being outside of the body for 56 hours, and could be effectively treated with drugs and therapeutic stem cells. Lung recovery over 36 hours is shown. (Image courtesy of Gordana Vunjak-Novakovic.)

Engineers and surgeons from Columbia University’s biomedical engineering faculty have announced the revival of a historical medical technique to save donated lungs for transplant surgeries.

Using “cross circulation,” a surgical procedure created in the 1960s to exchange blood flow between two patients, the team was able to develop a new method to support lungs outside the body in order to treat ischemia (restricted blood supply). The cross circulation method provides critical systemic and metabolic factors missing from current strategies for supporting living organs outside the body.

With this method, Columbia’s multidisciplinary team led by Gordana Vunjak-Novakovic, professor of biomedical engineering, and Matt Bacchetta, associate professor of surgery, were able to maintain the viability and function of the donor lung and the stability of the recipient for over 36 hours.

The number of donor lungs is smaller than the number of patients in need and many patients die while on the waitlist. Looking at this critical issue with donor lungs, the Columbia team focused on a specific issue within the process of transplantation.

Vunjak-Novakovic said this was the most complex study he and his team members have completed and one with high potential for clinical translation: “The lung is a masterpiece of ‘engineering by nature’ with its more than 40 cell types and a gas exchange surface area of 100 square meters—half a tennis court.”

“Our team worked hard to innovate a suite of imaging and targeted delivery technologies and ultimately completed this challenging, paradigm-shifting study in less than a year.”

One challenge was preventing the outer surface of the lung from drying out when exposed to the elements. The team designed a humidification system with ambient temperature control and a re-circulating warm water organ basin to replicate normal body temperature.

For adequate blood flow into and out the lungs during the cross circulation, the team employed a donor vessel as a “bio-bridge” and created a system capable of height and hydrostatic pressure adjustments with feedback-regulated pressure-controlled flow.

The study’s lead author, PhD candidate John O’Neill, stated that “Our cross-circulation platform will likely allow us to extend the duration of support to a week or longer if needed, potentially enabling the recovery of severely damaged organs.”

The platform has potential to recover other organs that are in high demand for transplant or in need of repair, such as livers and kidneys. Along with extra time, the Columbia team demonstrated several therapeutic interventions that improved and accelerated recovery.

For more news about the impact of technology on medicine, check out 3D Systems Medical Goes Virtual with VR OR Surgical Training.