The first successful double-lung transplant using Xvivo’s XPS system has taken place in the UK.
XPS is an ex-vivo lung perfusion (EVLP) platform that takes donated lungs considered to be either marginally acceptable or unacceptable for transplant and “reconditions” them outside of a human body.
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The first successful procedure was performed on 49-year-old Daniel Evans-Smith earlier this year at the Royal Papworth Hospital, which carries out more lung transplants than any other UK transplant centre. Since then, three others have received marginal lungs, treated in the XPS system.
EVLP for lung transplants is not a new technique and Xvivo’s XPS machine was approved by the FDA as far back as 2019. However, its adoption is yet to become commonplace in the UK.
When explanted lungs arrive at the recipient’s hospital, they are attached to an EVLP platform (such as the XPS one used at Royal Papworth) that mimics the human body, perfusing the organs with a special fluid and ventilating them.
The machine can maintain and occasionally improve the donor lungs, which can remain attached for up to four hours. During this time, specialists can assess the condition of the lungs, or administer short-term therapeutics if required. After at least three hours of testing, the lungs are removed for transplantation.
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By GlobalDataUntil Daniel’s transplant, EVLP transplants had used different machines or had only been used in clinical trial settings.
According to the surgical lead for transplantation at the hospital, Marius Berman: “Without this innovation, he [Daniel Evans-Smith] may still have been waiting for a transplant today.”
Evans-Smith commented: “The transplant has made a huge difference already. I haven’t had a cold, chest infection or symptoms that I had been suffering with in previous years so far, which will be down to the quality of the lungs.”
The average wait time for a lung transplant in the UK is 18 months, although there is variation across the country. Royal Papworth has the shortest waiting times for people on the lung transplant list and has the best organ utilisation rates. It is now also the only UK centre using EVLP for clinical cases.
There were 106 lung transplants performed across the 2021-2022 period in the UK, but more than 200 people remain on the waiting list. Health professionals hope that broader adoption of EVLP platforms, including Xvivo’s XPS, could ease wait times by enabling more organs to be deemed suitable for transplantation.
Xvivo CEO Christoffer Rosenblad said: “The implementation of similar EVLP programmes has enabled increased utilisation of donor lungs at transplant clinics around the world. The outcomes with marginal lungs transplanted after EVLP are also similar to those obtained with so-called ‘standard lungs’.”
