A lung transplant is an effective solution for people living with end-stage lung disease or those who have lost lung function. A transplant can bring back easier breathing and provide additional years of life. However, lung transplant surgeries still carry significant risk of complications and rejection.
In fact, up to 80 percent of donor lungs are discarded due to suspected injury, incompatibility, or, due to organ viability outside the body, a lack of time to investigate lung health and vitality prior to transplantation. This underscores the need for novel transplant technologies to improve outcomes for patients needing organ transplant.
Over the past decade, researchers at UHN’s Ajmera Transplant Centre and Toronto General Hospital Research Institute have focused on changing this dynamic – building on UHN’s rich history in lung transplantation including the first single and double lung transplant performed here in 1983 and 1986, respectively.
Developed in Toronto by leading thoracic surgeon-scientist Dr. Shaf Kashavjee (Chief of Innovation at UHN) and team, the Ex-Vivo Lung Perfusion (EVLP) system has revolutionized lung transplantation – increasing lung transplant access and organ viability. Following on the EVLP discovery, the identification of new biomarkers (i.e. particles found in blood, other body fluids, or tissues that can help identify an abnormal biological processes to help treat and identify disease) has further enhanced organ transplant potential with the development of rapid diagnosis in the operating room (OR).
EVLP allows the maintenance of donor lungs in a chamber – adapted to mimic body temperature and provide nutrients to keep the lungs metabolically active for hours before transplantation
The EVLP system has made groundbreaking strides in lung transplantation by enabling:
• the assessment of lung health prior to transplantation;
• reduced risk of infection and rejection;
• increased usability of donated lungs;
• reduced organ wait times; and,
• the development of commercial solutions to scale these technologies globally.
Born of a partnership with UHN and Canadian company SQI Diagnostics, a Canadian company committed to the development and manufacturing of life-saving respiratory health and precision medicine tests, the TORdx Organ Assessment Assay (TORdxTM) is a rapid diagnostic test helping assess lung health prior to transplant.
TORdxTM further builds on EVLP technology discovered at UHN, enabling surgeons to predict transplant outcomes by testing inflammation signaling proteins (biomarkers). Conducted right in the OR in only 45 minutes, the assay generates a UHN-developed algorithm called the Toronto Lung Score to determine lung suitability for transplantation.
The biomarker discovery used in the TORdx was patented and licensed to SQI Diagnostics with support from Commercialization at UHN.
In 2020, UHN and a team of transplant surgeons from across the country were awarded a $24M New Frontiers in Research Fund (NFRF) grant to advance ex vivo transplant technology. Leveraging the expertise of UHN’s researchers and national and international partnerships, the project will develop sophisticated ex vivo platforms that increase organ preservation; improve recipient immune response and organ tolerance; advance precision medicine to customize organs to individual patient needs.