StemCell Therapy

Lung transplants are difficult and risky. Only about 20 percent of organ donors have lungs that are usable; just over half of those patients fortunate enough to receive a donation survive through five years.

Researchers at the University of Virginia think they can improve outcomes for lung transplant patients. The university recently received more than $8.6 million in federal grants for a series of projects meant to take on the problem on multiple fronts.

Dr. Irving Kron and Victor Laubach are spearheading research into ex-vivo lung perfusion, or the use of therapy to rehabilitate donor lungs that may be considered unsuitable because of a donors medical conditions or complications during transportation of the organ.

Lungs are especially sensitive, said Laubach, a molecular physiologist at UVa, and the lungs of most multi-organ donors cant be used because they are badly damaged when the brain is deprived of oxygen. By attaching the donor lungs to a ventilator and treating it with drugs to prevent inflammatory injury and infections, doctors can make lungs suitable for transplants.

We are using that platform to treat those lungs to recondition them and improve their chances of becoming transplantable, Laubach said. If we do that, well significantly increase the donor pool.

Researchers at UVa envision the Medical Center becoming a hub for donor lungs that can be treated and made suitable for transplants.

Dr. Christine Lau is leading a trial of the anti-inflammatory drug regadenoson commonly used in stress tests in heart patients on donor lungs. Experiments on animals have shown that when the drug is pumped into lungs prior to a transplant, it reduces the patients inflammatory response one of the main causes of injury in patients.

[A transplant] causes your immune and inflammatory system to be up in arms, Lau said. What this drug does is shuts down those reactions.

Participation in the trial is completely mandatory, Lau said, but she estimates that more than 90 percent of lung transplant patients at UVa would be eligible for it.

Dr. Sasha Krupnicks research focuses on the patients specifically on suppressing the immune cells that attack the transplanted lung that are less harmful than the current approach.

Currently, transplant patients receive a cocktail of drugs that suppress the entire immune system, putting them at higher risk of infection. Krupnick is experimenting with the use of cells or antibodies that focus on the problem actors in a patients immune system.

What weve discovered is that when we transplant an organ, theres a certain cell population that infiltrates the organ and produce nitric oxide, Krupnick said. If harnessed in the right way, they can kill the harmful T cells.

Ideally, patients would receive an injection before the procedure, reducing the need for drug treatments afterward. Most patients would be off the drug regimen 10 days after the transplant, Krupnick said.

UVa researchers also are hoping to prevent the injuries that go undetected immediately after lung transplant surgery. Many patients go one to two years after the procedure before showing signs of reperfusion injuries, which are typically caused by the bodys rejection of the new organ.

The tools surgeons currently have are fairly crude; it comes down to a chest X-ray, Laubach said. This new grant we have is going to enable us to use new imaging probes.

Using SPECT (short for single photon emission tomography) imaging, doctors should be able to detect these problems and intervene more quickly, which could save lives, Laubach said.

Laubachs team also is planning to use imaging to look at the causes of these injuries, and to get a better understanding of why the body so often rejects transplants.

By looking at all phases of the lung transplant process, UVa researchers are hoping they can make it less difficult for surgeons and less risky for patients. It will take a team effort to make that happen, Laubach said.

We have probably one of the best lung transplant research programs in the country, if not the best, he said. The collaborations have allowed this to happen.

Read this article:
UVa researchers working on lung transplants get $8.6M boost - The Daily Progress

This entry was posted on July 4, 2017 at 11:47 pm and is filed under Immune System. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |