Making history: Lung transplant marks first in Texas using new ex-vivo technology

In early 2016, UT Southwestern Medical Center surgeons performed the first lung transplant in Texas using donated lungs treated with a technology known as ex-vivo lung perfusion (EVLP).

EVLP allows physicians to evaluate and recondition lungs, making lungs that would have been unsuitable for transplantation potentially viable. UT Southwestern is one of 16 medical centers across the country – and the only one in Texas – participating in a national clinical trial of the technology.

“Currently, more than 70 percent of potential donor lungs are deemed unusable,” said Dr. Fernando Torres, Professor of Internal Medicine and Medical Director of Lung Transplantation at UT Southwestern. “EVLP technology is an assessment tool that allows us to evaluate organs that are marginal over an extended period of time.”

In 2015, 2,057 lung transplants were performed in the U.S., but more than 200 people died while awaiting a lung transplant, including 22 Texans, according to data from the United Network for Organ Sharing (UNOS), the nonprofit organization that manages the nation’s organ transplant system. EVLP is expected to increase the number of lungs available for transplant by 10 to 15 percent.

(Dr. Pietro Bajona (left), Dr. Amit Banga, Assistant Professor of Internal Medicine, and the rest of the EVLP team assessed the lungs using new ex-vivo lung perfusion technology.
Dr. Pietro Bajona (left), Dr. Amit Banga, Assistant Professor of Internal Medicine, and the rest of the EVLP team assessed the lungs using new ex-vivo lung perfusion technology.

“Some of the lungs we see are clearly not usable because of infections, bad contusions, and so on, but with others, it’s simply not clear,” said Dr. Pietro Bajona, Assistant Professor of Cardiovascular and Thoracic Surgery and Director of the EVLP Program. “We can put the questionable lungs in the machine, ventilate them, perfuse them with a special solution, and then after a few hours test them.”

In April 2016, marking a historic milestone in UT Southwestern’s lung transplant program, former Oklahoma school superintendent John Herzig became the first patient in Texas to be transplanted with lungs that were evaluated with EVLP technology. His health had been deteriorating due to pulmonary fibrosis, a scarring of the lungs that leads to severe breathing problems.

Following the donation of a potentially viable set of lungs, Dr. Bajona tested the lungs in an ex-vivo device. After about three hours, the team of physicians determined the lungs were usable, and Dr. Matthias Peltz, Surgical Director of Cardiac Transplantation and Mechanical Circulatory Support and Associate Professor of Cardiovascular and Thoracic Surgery, led the surgical team that performed the transplant.

“I’m so grateful to the family who agreed to donate these lungs,” Mr. Herzig said, “and thankful for the new technology that helped make them available, so now I’ll have that opportunity to play with my grandson and watch him grow.”