Research Group

  • Dr Shaf Keshavjee, Principal Investigator
  • Dr Kang Chang Hyun, Research Assistant

Location

  • University Health Network, Toronto, Canada

Title

  • Molecular Techniques to Improve Safety of Donor Lungs for Transplantation

Lung transplantation has become the mainstay of therapy for patients suffering from many types of end-stage lung disease (e.g. emphysema, pulmonary fibrosis, pulmonary hypertension and cystic fibrosis) refractory to medical management. Most of the patients that have a chance to receive new lungs are alive 5 years after transplantation and their quality of life is significantly improved. Unfortunately, the number of patients requiring lung transplantation has been increasing and greatly exceeds the number of donor lungs available. As a result, the death rate on the waiting list is 20% to 30% in most lung transplant centers.

The best alternative would be to expand the number of donors. Indeed, using current criteria to select donor lungs we are able to use only 15% to 25% of the lungs that are offered to us from brain dead donors; 75% to 85% of donor lungs cannot be used because they are already damaged (e.g. inflammation, pneumonia, etc.). Attempts to use these lungs for transplantation carry an increased risk of complications. Hence, strategies to more accurately determine the overall quality of donor lungs combined with methods to repair injured lungs would significantly increase the safety and number of transplants performed each year.

Our project aims to develop more accurate methods (biomarkers – genes) to determine donor-lung quality using tissue biopsies from the organ before transplantation. If injury is present, we will perform donor-lung treatment and repair using ex vivo (outside the body) gene therapy (a beneficial gene is inserted into the lung cells which in turn produces a new protein in order to heal the surrounding cells). We will then look to discover novel markers of donor-lung injury and repair, so that in the near future only truly repaired donor lungs will be used, thus improving outcomes in lung transplantation.

Progress Report