First lung transplant in bid to increase life-saving organ operations

This was the first lung transplant in the UK's revolutionary new 'three hospital' transplant scheme. The lungs - which would otherwise not have been used - instead travelled hundreds of miles between three hospitals to save a life.

This new model is expected to eventually increase the number of transplants by around 20%, potentially helping save or improve an additional 750 lives every year.

Increasing the number of life-saving organ transplants

The lung was successfully transplanted through the UK's landmark new Assessment and Recovery Centres (ARCs) pilot programme, marking a major milestone in efforts to increase the number of life-saving organ transplants. A national collaboration delivers first lung transplant through new Assessment and Recovery Centres in an effort to increase the number of life saving organ transplants.

The ARCs programme introduces a new model of transplantation in which an organ is donated at one hospital, taken to a second hospital to be placed on a perfusion machine where its function is carefully assessed, and then transplanted at a third hospital.

Developed by NHS Blood and Transplant, in collaboration with the cardiothoracic transplant community, and funded by the Department of Health and Social Care, ARCs is the first national programme of its kind in the world.

It is expected to eventually increase the number of transplants by around 20%, potentially helping save or improve an additional 750 lives every year.

The first transplanted lungs were donated at a hospital in the north of England. They were then transported to Royal Papworth Hospital in Cambridge for ex vivo lung perfusion (EVLP) assessment (1). They were then transported to Queen Elizabeth Hospital Birmingham for transplant. The recipient is recovering well and has been discharged from hospital.

Andrew Fisher is Professor of Respiratory Transplant Medicine at Newcastle University and the Lung Clinical Lead for the ARCs Programme at NHS Blood and Transplant, which has introduced the ARCs programme. He said: "I am delighted that the first lung transplant has been performed using donor lungs that have had their quality checked in an ARC pilot site before being sent to another transplant centre for a patient on their waiting list.

"All transplant teams now have the ability to ask for donor lungs where there is uncertainty if they can be used, to be sent to an ARC to be tested. It shows the potential for this to increase the number of suitable lungs available for transplant and to make lung perfusion technology available to every patient on the waiting lists across the country.

"The transplant represents not only a significant clinical achievement but is also a celebration of the power of collaboration across the UK's cardiothoracic and transplant community, that has come together to design, launch, and deliver the ARCs pilot programme.

"We should also remember that none of this is possible without the generosity of the donor and all families who support donation. They are lifesavers."

Minister of State for Health Karin Smyth said: "This is a fantastic example of British medical innovation saving lives. I am incredibly proud that the UK is hosting the first national programme of this kind anywhere in the world, giving patients a better chance of a life-changing operation.

"This breakthrough could help save or improve an additional 750 lives every year, and it is a testament to the skill and collaboration of our NHS staff and scientists that the UK is a world leader in this field.

"We are determined to build an NHS fit for the future, one that harnesses cutting-edge science to improve outcomes for patients. This is exactly the kind of innovation that will help us do that."

"important milestone for transplantation"

The ARCs model has been designed to make the best possible use of donated organs by providing transplant teams with more information about organ function before a transplant takes place.

Currently, some organs fall into a clinical 'grey area', where initial assessments do not provide enough information to confidently determine whether they are suitable for transplant. Because decisions must often be made within a matter of hours, such organs can be declined out of caution.

Through the ARCs programme, organs can undergo additional functional assessments using machine perfusion technology at the second hospital, which allows clinicians to evaluate suitability for transplant in greater detail. This gives a transplant team at a third hospital greater confidence when considering organs for transplantation. The programme has significant potential to unlock crucial additional transplant activity, particularly for lung patients.

A liver has already been transplanted through the pilot programme, and additional pilot sites, including kidney pilot centres, will launch over the coming months.

If the pilot programme is successful, ARCs could become the standard approach for assessing organs that require further evaluation before transplantation.

The programme builds on over a decade of pioneering work in organ perfusion undertaken by transplant centres across the UK.

By bringing expertise together in a coordinated national programme, ARCs aims to increase access to transplantation, support organ sharing across the country, and establish a consistent national approach to assessment and preservation.

The ARCs programme will have 15 pilot sites, when all are rolled out (2). If this pilot program is successful and a UK national service created, several dedicated and specialist ARC centres would be created. In the future, there is potential for organs to be treated during machine perfusion to improve their quality and how well they function after transplantation

Marius Berman, Clinical Director for Transplantation at Royal Papworth Hospital NHS Foundation Trust, which was the ARCs lung pilot site performing the perfusion, said: "Transplantation is truly transformative and a core activity at Royal Papworth, so we are proud to have played an instrumental part in a wider national cardiothoracic community effort.

"We were pleased to contribute our expertise in ex vivo lung perfusion for this first lung transplant in the ARCs programme. This important milestone reflects years of innovation and collaboration across the transplant community.

"Our hope is that this pilot enables more donor lungs to be safely assessed and transplanted, giving more patients the opportunity to receive a life-changing transplant."

Mr Aaron Ranasinghe, Consultant Heart and Lung Transplant Surgeon and Transplant Programme Lead at University Hospitals Birmingham NHS Foundation Trust, which was the transplanting hospital, said: "This landmark transplant demonstrates what can be achieved when NHS organisations collaborate in new and innovative ways to make the very best use of donated organs. Through the ARCs programme, expertise from specialist teams across the country can be brought together to assess, preserve, and successfully transplant organs that may previously have been declined.

"For our patients, this represents more life-changing opportunities, and it is an exciting glimpse of the future. By enabling more detailed assessment of donor organs and extending the opportunities for organs to reach suitable recipients, we are honouring the precious gift from donors and their families."

Find out more about Newcastle University's role in the life-changing scheme.

(Adapted with thanks to NHS Blood and Transplant.)