In the past, transporting a set of lungs from a donor in Alaska to a waiting patient in North Carolina would have been considered a lost cause. But a preservation system from Paragonix Technologies completed the trip, safeguarding the organs for more than 13 hours and a journey of 4,788 miles.
The high-stakes transplant procedure set a new record for the company’s LUNGguard system, pushing past its intended organ storage time of up to eight hours and opening up the number of potentially successful options for surgeons.
Shaped like a small, rolling cooler, the FDA-cleared device is designed to maintain a steady temperature between 4 degrees Celsius and 8 degrees Celsius for as long as 40 hours—all without the use of ice, which can cause freezing injuries to the delicate tissue.
The procedure was completed by the transplant team at Duke University Hospital, with help along the way from three other national medical centers. The same Alaskan donor also provided a heart that was delivered to a separate patient in Washington state—a 1,579-mile trip, taking over seven hours—using Paragonix’s similar SherpaPak cardiac transport system.
Overall, two lives were saved after five flights and 31 total hours from procedure to procedure, according to the company. That may not have been possible using ice and the same off-the-shelf coolers typically seen at a summer barbecue, which have served as the standard-of-care for more than five decades.
“While we consider many factors in selecting a donor, distance is a significant risk factor to moving forward,” John Haney, M.D., an assistant professor of surgery at Duke University, said in a statement. “Transplant centers around the country are seeking ways to overcome the challenges associated with safely transporting organs further and new technologies show promise.”
Lungs also present specific challenges when compared to other organs like hearts and kidneys. They are more likely to be damaged during the death of the donor, such as from ventilator-associated injuries or the aspiration of fluids. And during transport, changes in air pressure aboard an airplane can cause the tissue to inflate and stretch like a balloon.
Paragonix’s LUNGguard seals the organs within three sterile bags before holding them separately from proprietary cooling packs and monitoring temperatures through a Bluetooth-connected app.
The company also reported the first-in-human use of its LIVERguard preservation system last December by a transplant team at the Mayo Clinic’s Florida location. The device, similar in form to the LUNGguard, is intended to store donor liver tissue for up to 15 hours.