Sensor Predicts Which Donated Lungs Will Fail After Transplant

the_newsbeagle writes: A lung transplant can be a life-saving intervention—but sometimes the donated lung stops working inside the recipient's body. This "graft dysfunction" is the leading cause of death for transplant patients in the early days after surgery. While lab tests can look for genetic biomarkers of inflammation and other warning signs in a donated lung, such tests take 6-12 hours in a typical hospital. That's too slow to be useful. Now, researchers at University of Toronto have invented a chip-based biosensor that can do quick on-the-spot genetic tests, providing an assessment of a lung's viability within 30 minutes.

Comments

Can you do this pre-mortem?

[Sowelu]

I wouldn't mind having a blurb or QR code on my driver license that says which of my organs are most likely to be viable.

Re:Can you do this pre-mortem?

[fuzzyfuzzyfungus]

My (layman's) understanding is that viability is a factor of interaction between the recipient and the donor organ, not merely a function of the donor, so would be tricky to label ahead of time.

For grafts where they have the luxury of (relatively) large amounts of time, and a non-fatal donation process(like bone marrow), they will screen for recipient/donor suitability ahead of time; but for donor organs where the donor is supposed to die first, time is very, very, limited and supplies are extremely tight. Much harder to preemptively do any substantial testing and a much greater incentive to shovel the organs into someone before they expire, since odds are good that that person won't get a second chance.

That's why this high speed method is so valuable: since the organs are so scarce, you don't want to waste one if it will just kill the patient anyway; but the clock is ticking from the time the organ becomes available until it becomes nothing but meaty medical waste.

Re: Can you do this pre-mortem?

[Cobalt Jacket]

Ischemic time (the time a lung can survive outside the body) is about four hours. Lungs are also delicate. I'll also add: the survival rate for lung transplants is atrocious. Not only are they risky at transplant time, but people tend to survive about five years post-, which is about as bad as it gets in transplantation. Disclaimers: 1) My son is a heart transplant recipient. 2) My brother-in-law was a failed lung transplant recipient. 3) I serve in a policy-making role for OPTN, which coordinates all solid organ transplants in the U.S.

Re:Can you do this pre-mortem?

[The-Ixian]

The problem I have with donating organs is they only go to financially viable recipients.

Deliberate choices are made at the time of harvesting which ensure that only those who are likely able to pay will get the organ.

This makes me angry enough that I removed my donor status from my driver's license.

Re:Can you do this pre-mortem?

[KingMotley]

Would you prefer your organs went to incarcerated criminals to insure they live long enough to serve the longest maximum sentence before they die? Or was it the street corner wineo that you were concerned about?

Re: Can you do this pre-mortem?

[Anonymous Coward]

Ischemic time (the time a lung can survive outside the body) is about four hours. Lungs are also delicate.

I'll also add: the survival rate for lung transplants is atrocious. Not only are they risky at transplant time, but people tend to survive about five years post-, which is about as bad as it gets in transplantation.

The survival rate is atrocious for some Lung Transplant programs because they don't use quality lungs. Not all. The Cedar Sinai lung transplant program in Los Angeles has a very, very good survival rate because (in their own words) they have quite a high standard on the lungs that they transplant. If they find ANYTHING wrong with the lung that they are about to transplant, they don't proceed with the surgery. I know, because my father got a lung transplant from them and I had to be there for the consultations and the surgery. With Dad "on call" for the lung transplant surgery (and I was too), he got called and prepped for surgery 5 times in a 6 month time frame. 4 of the times (including once when we were 5 minutes away from Dad being wheeled in to surgery) the transplant was called off because the transplant team did not like the looks of the transplant lungs.

You are mostly right about the post surgery survival rate. At least at that time, there seemed to be a spike of deaths at the 2nd through 4th years after the surgery. As was explained to us by the surgeons, this was due to people feeling really, really good after the surgery because the surgery fixed their breathing and they could DO things again and not be tied to an oxygen machine. They therefore 1) forgot to take there anti-rejection medications and 2) Put themselves into situations that stressed their immune suppressed body to the failure point (no, you can't play in the dirt anymore. It's DIRT, with lots of nasty things in it. And you can't have cats. From a germ standpoint, one of the worst animals to have indoors. Honestly). So the first couple of years knocks a bunch of people out. But that first spike of deaths is really preventable with good education. And after 5 years the survival rate is very good.

I did actually lose Dad at around the 5 year point. It was due to him changing to a less kidney harming anti-rejection medication and him not being honest and forthright with the doctors regarding the aftereffects he was feeling. The newer anti-rejection drug, while less harming to the kidney's, had a known 5% rate of massive, almost allergic, transplant reaction to patients, but it manifests itself slowly and if your honest with your doctor about how your feeling they can catch it very easily before it does harm. However, if you don't tell them then you get a massive rejection episode down the line, which is what happened. He started feeling bad on 24th Dec, passed away Jan 19th after very, very heroic efforts by the wonderful staff at Cedar Sinai.

I think what you will find is that lung transplant programs at hospitals fall into two categories: those that are really really good and those that are really bad. Unfortunately, when you average them out, the bad programs drag down the good ones in the statistical survival #'s to make them all look bad. My advice to anyone looking into getting a lung transplant is ask for the programs survival #'s to choose a good one. Or just go to Cedar Sinai's program in Los Angeles.

Gordon

Re: Can you do this pre-mortem?

[Flymo2]

Move to a civilised country.

Would prefer to know before the transplant.

[Voxol]

Bit late otherwise.

Re:Would prefer to know before the transplant.

[Trepidity]

That's exactly the point of this, isn't it? The article says (bold added): "The new sensor can predict, before transplantation, which donated lungs will malfunction."

According to the article, the previous tests took too long, so by the time test results came back, the lung would no longer be viable to transplant. This one can get results faster, so surgeons can wait around 30 minutes before deciding whether to go ahead with the transplant or not.

Re:Would prefer to know before the transplant.

[fuzzyfuzzyfungus]

Presumably depends on the location: major population centers or noted transplant hospitals can probably get the runner-up in pretty quickly(if they aren't already hospitalized because of the effects of needing a lung, there's nothing like the prospect of horrible death to get somebody moving); and presumably the ethics of not providing the original first-in-line with an organ that will kill him and giving it to #2 instead are pretty straightforward.

If the donor hits a tree and suffers massive head trauma out in some rural area, logistics may become considerably more challenging. Even for effectively unlimited money you can only get transport lined up so fast.

Re:Would prefer to know before the transplant.

[Voxol]

yesthatsthejoke.tumblr.com

Re: Would prefer to know before the transplant.

[Cobalt Jacket]

What generally helps is to keep the donor on life support as long as possible. This is why clinical death is often declared long after an MRI, etc., indicates brain death.

Re:Would prefer to know before the transplant.

[morgauxo]

Worst case it goes to the soup kitchen. Waste not want not.

horrible news

[davell logan]

I hope these facts are not true.

Was it 3d printed and bought with bitcoin?

[tomhath]

If the chip wasn't made on a 3D printer and paid for with bitcoin this story shouldn't be on slashdot.