In my past post, Deeper Questions, I mentioned that my transplant center, Hospital of the University of Pennsylvania (UPENN) uses a technology called ex-vivo lung perfusion to make transplanted lungs more viable, allowing them to be sustained outside the body for longer periods, & potentially reversing damage that might have once caused lungs to not be suitable for transplant. They have some excellent information at the website as part of the lung transplant program page that outlines this technology (in fact, that’s where I found the image I used to accompany this post) what exactly it is, & how it’s led to more transplants & better outcomes.
This video (time 8:51) is not the ex-vivo process in action, but an excellent educational video of why this technology is important. It’s actually led by Andrew Schorr, a renowned clinician & founder of Patient Power (who I know from my days working at Medscape) interviewing Dr. Jason Christie, as to why UPenn leverages this technology.
I found that fascinating but I was equally excited to see a program about the process actually being used in a transplant setting. The whole technique is actually also referred to as warm perfusion. I found a different system, the Organ Care System (OCS) , by Transmedics, highlighted quite well the advantages of the warm perfusion methods versus the “old school” methods of cold-cooling organs.
It gave me such a great appreciation for these new technologies that I feel fortunate that if the time comes I have a center that utilizes this technology.
TECHKNOW: Al Jazeera America (time 25:02) had a wonderful segment (just reposted on 7/16) on a woman with idopathic pulmonary fibrosis (IPF) who was in dire need of a lung transplant. This followed her as part of a randomized study in which transplant surgeons would not know which method of preservation (old standard cold cooled vs the Organ Care System (OCS)) would actually be used until it was randomized when she received her “call” for lungs.
It was a remarkable video to watch both for the science, but also the captures a window of what transplant recipients face & provide true insight on how these 2 warm perfusion technologies work & why they are so critically important.
But my main question after watching this system was what is the difference between the Organ Care System (OCS) & the XVIVO system? (This is the ex-vivo system in use at UPENN, even though they don’t appear as a center on XVIVO‘s website. Dr. Cantu, a Penn transplant surgeon, did champion the system & helped press for FDA approval.)
The XVIVO has a solution called the STEEN solution with it that is designed to rehabilitate “marginal” lungs (which I also mentioned in my past post, Deeper Questions). XVIVO is a Swedish company that was founded in 1998. The device has been used since around 2012, but was FDA approved in 2014.
The Organ Care System (OCS) does many of the same things the XVIVO system does, but I don’t see an equivalent solution to the STEEN solution, at least not from what I can see from the Transmedics website. It simply uses blood. However, they have a very short but informative patient video on their site that also can speak to the larger advantages of using a warm perfusion system versus the standard cold transport methods. Transmedics was also founded in 1998 & is located in Andover, Massachusetts. Their device is not FDA approved yet, but is currently undergoing clinical trials & is still considered investigational.
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