New NHS Technique Enables First Life-Saving Lung Transplant from Previously Unusable Organs
A pioneering procedure in the UK has successfully transplanted lungs that might have otherwise been discarded, potentially saving hundreds of lives annually.
A British man has become the first recipient of a life-saving lung transplant made possible by a new National Health Service (NHS) technique that could potentially save up to 750 lives each year. The procedure involved using donor lungs that, due to their condition, might have ordinarily been rejected for transplantation.
Joe McConnell, a 62-year-old carpenter from South Wales, was critically ill and reliant on oxygen before receiving the donor lungs. These organs were transported between three different hospitals and kept viable in a specialized "lung-in-a-box" machine, allowing doctors to monitor their function and improve the chances of a successful transplant. This marks a new UK and European record for the furthest distance perfused lungs have traveled for transplantation outside of North America.
Currently, many donated lungs are rejected before removal because specialists cannot be certain of their suitability. Lungs that are retrieved are typically packed in ice, but their delicate nature leads to a significant proportion being deemed unsuitable after examination, often resulting in last-minute cancellations of transplant operations. Approximately 17% of individuals on the lung transplant waiting list die each year.
The groundbreaking pilot program, centered at Royal Papworth Hospital in Cambridge, allows lungs to be placed in the "lung-in-a-box" machine. This device pumps oxygenated blood and nutrients to the lungs, keeping them functioning and allowing for an assessment period of up to 12 hours. This process can identify lungs that might have been borderline or difficult to assess, potentially rejuvenating them for use and offering hope to patients on the transplant waiting list.
In McConnell's case, the lungs were donated at a hospital in the North of England and transported to Royal Papworth Hospital in one of the perfusion machines. After undergoing detailed assessment, they were sent to Queen Elizabeth Hospital in Birmingham for his operation. McConnell had previously been called for potential transplants seven times, but each occasion was unsuccessful until this procedure.
He described his condition before the transplant as "dying," stating he was "grey, blue and down" and required an oxygen tank to survive. Ten weeks after the surgery, he reports feeling "fighting fit" and has returned to walking with his wife and their dog.
The technique employed, known as ex vivo machine perfusion (EVLP), is part of the Assessment and Recovery Centres (ARCs) program, developed by NHS Blood and Transplant (NHSBT) in collaboration with cardiothoracic transplant teams and funded by the Department of Health and Social Care. Fifteen hospitals in England have perfusion machines that mimic the human body's environment, allowing organs to be assessed before transplantation. More than half of lungs assessed this way are transplanted, double the rate of those placed on ice.
Marius Berman, Consultant Cardiothoracic & Transplant Surgeon and Clinical Director for Transplantation at Royal Papworth Hospital NHS Foundation Trust, explained that EVLP provides additional information about lung performance, addressing the challenge of making transplant decisions with limited, time-sensitive data. He noted that the development of ARCs aims to overcome logistical and resource barriers to national access to this technology.
Royal Papworth Hospital established its clinical EVLP transplantation program in 2024 with NHS England funding, providing the infrastructure for the ARCs pilot. This initiative seeks to improve both the number of lung transplants and equitable access across the UK. NHSBT predicts that if successful, the ARCs program could facilitate up to 750 additional life-saving and life-improving transplants annually.