New techniques for increasing lung transplantation frequency
Principal investigator; Steen, Stig, Professor, MD/PhD
Clinical speciality: Thoracic surgery
Co-workers: Trygve Sjöberg, Associate professor
The worldwide shortage of organ donors results in limited possibilities to treat end stage pulmonary diseases. Twenty percent of the patients on the waiting list die before lung transplantation. It is possible to entirely overcome the shortage of lungs for transplantation by the use of organs from people how dies after failed cardio-pulmonary resuscitation or after reconditioning of rejected donor lungs. The prerequisite for NHBD is that the deseased has not been negative to organ donation and that the next of kin accept the procedure. A special recondition equippment developped by us, is needed to recondition lungs that primarily was rejected
To preserve the lungs in situ, cold Perfadex solution has to be flushed into the pleurae through thoracic drainage cannulas within 1 hour after declaration of death. The responsible physician shall inform the next of kin about the death, the possibility of organ donation and that immediate cooling of the lungs is necessary. If the next of kin is not negative to the procedure, cooling in situ is initiated. When this is compleated, donation (explantation of organs) can be discussed during several hours. If donation is accepted the heart-lung block will be extirpated and brought to Lund University Hospital. Lungs that is rejected as donor lungs will be brought to Lund for reconditioning. The lung function will be tested ex vivo by means of a lung evaluation solution mixed with red blood cells using a special lung perfusion machine. If the lung function is good and no other contraindications are found, the selected recipient will be brought to the hospital for transplantation.
Ambulance personnel, staffs at emergency care unit, internal medicine and cardiology units at the University Hospital of Lund and six remote hospitals have so far been trained for NHBD. The goal is to educate personnel at all hospitals and ambulances in Sweden.
Link to project homepage: http://
5 recent original publications
Steen S, Sjöberg T, Pierre L, Liao Q, Eriksson L, Algotsson L
Transplantation of lungs from a non-heart-beating donor
Lancet. 2001; 357: 825-829
Steen S, Liao Q, Wierup P, Bolys R, Pierre L, Sjöberg T
Transplantation of lungs from non-heart-beating donors after functional assessment ex vivo
Ann Thorac Surg. 2003; 55: 244-252
Wierup, P.; Haraldsson, A.; Nilsson, F.; Pierre, L.; Schersten, H.; Silverborn, M.; Sjoberg, T.; Westfeldt, U.; Steen, S.
Ex Vivo Evaluation of Nonacceptable Donor Lungs
The Annals of Thoracic Surgery. 2006; 81: 460-466
Steen S, Ingemansson R, Eriksson L, Pierre L, Algotsson L, Wierup P, Liao Q, Eyjolfsson A, Gustafsson R, Sjöberg T.
First human transplantation of a nonacceptable donor lung after reconditioning ex vivo.
Ann Thorac Surg . 2007; 83: 2191-2195
Ingemansson R, Eyjolfsson A, Mared L, Pierre L, Ekmehag B, Gustafsson R, Johnsson P, Koul B, Lindstedt S, Lührs C, Sjöberg T, Steen S.
Clinical transplantation of initially rejected donor lungs after reconditioning ex vivo.
Ann Thorac Surg. 2009; 87: 255-260
Further publications here (new window)
|Total financing:||10.5 MSEK||Gov grant for clinical research ("ALF"):||0.9 MSEK|
|Total external financing:||7.0 MSEK||Natl and intl prioritized grants:||0.3 MSEK|