From left: Hari Mallidi cuts a cake celebrating a lung transplant milestone at BWH with Lung Center colleagues Bruce Levy and Raphael Bueno.
Since the early 1990s, Brigham and Women’s Hospital (BWH) has been a leader in lung transplantation. This year, surgeons at BWH’s new Lung Center accomplished a major milestone by performing a record 51 lung transplants since October 1, 2015. This is the highest number of lung transplants ever performed in New England with the previous record being 36 in a comparable time period.
“The Lung Center was able to increase the number of lung transplants performed annually by increasing staffing to include four surgeons whose main focus is to perform transplants, and by making new technologies available patients,” said Dr. Raphael Bueno, Chief of Thoracic Surgery at BWH, and co-director of the Lung Center.
The first technology utilized in the Lung Center that helped expand the number of organs available for transplantation is extracorporeal membrane oxygenation, or ECMO, an intensive care technology that takes over the work of the lungs temporarily for patients waiting for transplantations. Acting as a lung, the technology delivers oxygen to a patient’s bloodstream, allowing time for damaged lungs or a stressed heart to rest and recover.
“We added the ECMO program to manage patients with acute heart failure, lung failure, or combined heart and lung failure. With ECMO, we also have time to evaluate patients for more advanced therapies, such as durable ventricular assist device, heart transplant, or lung transplant,” said Dr. Hari Reddy Mallidi, Section Chief, Transplant and Advanced Lung Diseases in the Division of Thoracic Surgery at BWH.
The Lung Center also began utilizing ex-vivo lung perfusion (EVLP), a procedure used to minimize swelling in donor lungs in an effort to make them suitable for transplantation. EVLP involves keeping donor lungs ‘breathing’ outside of the body and providing them with nutrients and blood-substitutes. The method also removes donor white blood cells resident in the donor lungs, which could play a part in reducing the recipient’s immune response and therefore minimize the risk of rejection.
“EVLP has the potential to perfuse lungs infected with hepatitis C or pneumonia, for example, with anti-viral medications that would essentially cure the lungs and then make them suitable for transplantation. I expect that EVLP will allow us to perform an additional 10 to 20 transplants this year,” said Dr. Bueno.