Doctor Stories
Ex Vivo Lung Perfusion Expands Donor Pool for Lung Transplant Program
02.29.2024
Stanford Health Care is a national leader in lung transplantation. It is among the top 10 centers for lung and pulmonary surgery, according to 2023-2024 U.S. News and World Report national rankings.1
Data from the 2024 Scientific Registry of Transplant Recipients2 show that the Lung Transplant Program continues to demonstrate some of the best outcomes in the nation, including:
- Faster lung transplants relative to the national average (waitlist mortality rate: 10.3% vs. 16.3%" WITH "Lower waitlist mortality rates relative to the national average (waitlist mortality rate: 10.3% vs. 16.3%). Based on the SRTR’s 5-Tier Outcome Assessment (srtr.org) methodology, Stanford is #3 in the nation and #1 in CA and in Region 5. Region 5 includes California, Nevada, Utah, Arizona, and New Mexico.
- Higher lung acceptance rates relative to the national average (organ offer acceptance ratio: 1.98 vs. 1.0)
- Excellent post-transplant patient survival rates exceeding national averages (1-year: 89.92% vs. 88.72%)
- Excellent post-transplant graft survival rates exceeding national averages (1-year: 90.33% vs. 88.14%)
- The highest number of heart-lung transplants in the nation, with 1-year patient and graft survival rates exceeding the national averages
CARE AT STANFORD
Our pulmonologists, surgeons, and their teams offer expert lung transplants for people with advanced lung diseases such as COPD and cystic fibrosis.
650-723-3633
Mark Nicolls, MD
"Ours is among the busiest lung transplant programs in the country and the busiest combined heart/lung transplant program," says Mark Nicolls, MD, chief of Pulmonary, Allergy and Critical Care Medicine. "In an effort to broaden access to lung transplantation, we have expanded our use of ex vivo lung perfusion (EVLP) as a method to optimize lungs following their removal from the donor."
Expanding the pool of transplant-ready lungs
The waitlist for people needing lungs surpasses the availability of donor organs. However, data also show utilization rates of donor lungs as the lowest among organs at ~19%.3 Much of this discrepancy is a consequence of strict criteria that designate many lungs as unsuitable. Reasons for disqualification range from donor health status to ischemic time (duration between organ procurement and transplant).
In recent years, increased use of EVLP has altered the landscape of lung transplantation. It enables donor lungs to be re-conditioned, repaired, and/or preserved. EVLP simulates physiological conditions in a closed, temperature-controlled system. A ventilator and filtration unit maintain air flow while the lungs are perfused with solution containing nutrients and therapeutics.
Importantly, EVLP affords clinicians the time necessary to:
- Evaluate lungs to determine their likelihood to promote transplant success
- Rehabilitate lungs to recover or improve their function and suitability for transplant
Offering hope to those waiting
Ultimately, EVLP allows clinicians to be more aggressive in their decision-making regarding whether to accept a ‘marginal’ organ. The ability to convert marginal lungs into those suitable for transplantation translates to shorter waiting lists, decreased waitlist mortality, and a potentially larger pool of qualified recipients.
Learn more about Stanford Health Care’s Lung Transplant Program.
References:
- "Best Hospitals for Pulmonology & Lung Surgery", U.S. News and World Report, accessed January 18, 2024.
- "Lung, Stanford Health Care", Scientific Registry of Transplant Recipients, accessed January 20, 2024.
- Smith S, Trivedi JR, Fox M, van Berkel, VH. Donor lung utilization for transplantation in the United States. J Heart Lung Transplant. 2020;39(4):S374.
About Stanford Health Care
Stanford Health Care seeks to heal humanity through science and compassion, one patient at a time, through its commitment to care, educate and discover. Stanford Health Care delivers clinical innovation across its inpatient services, specialty health centers, physician offices, virtual care offerings and health plan programs.
Stanford Health Care is part of Stanford Medicine, a leading academic health system that includes the Stanford University School of Medicine, Stanford Health Care, and Stanford Children’s Health, with Lucile Packard Children's Hospital. Stanford Medicine is renowned for breakthroughs in treating cancer, heart disease, brain disorders and surgical and medical conditions. For more information, visit: www.stanfordhealthcare.org.