HEALTH-FITNESS

Ohio State surgeons use new procedure to restore damaged donor lungs

Mark Ferenchik, The Columbus Dispatch
Dr. Bryan Whitson poses with George Kosta as Kosta's wife, Leslie, takes a photograph of them at the Ross Heart Hospital at Ohio State University.

In December, George Kosta was told his lungs were failing him.

Doctors diagnosed pulmonary fibrosis — scarring of lung tissue — and told the 63-year-old Dayton man he needed a new pair of lungs.

However, the pool of donor lungs is limited in the United States, where 1,437 people were waiting for a transplant as of Sept. 2, according to the United Network for Organ Sharing. That included 125 people in Ohio.

As many as 80 percent of donor lungs are damaged by lifestyle or as a result of the manner of death, such as drowning or asphyxiation, which typically would make them bad candidates for transplant.

But now, surgeons at Ohio State University’s Wexner Medical Center are using a procedure called ex-vivo lung perfusion to expand the pool by restoring lungs that would have been rejected in the past.

On Aug. 31, Kosta received two restored lungs during a 7½-hour surgery that started after 2 a.m. A week later, he was lying in his hospital bed, breathing without an oxygen feed.

“I’m feeling fantastic,” said Kosta, who had endured double-bypass heart surgery in 2009. He said that participating in a clinical trial for the lung procedure was a no-brainer: “What else did I have?”

>>> Video: Lung transplant at Ohio State

On Monday, a second transplant using restored lungs was performed at Ohio State's Ross Heart Hospital.

“We have done lung transplants before, (but) they were perfect lungs,” said James Ralston, the hospital’s director of perfusion who assisted on the surgeries.

It works this way: The medical team places damaged donor lungs in a sterile plastic dome attached to a ventilator, pump and filters. The machine inflates the lungs and floods them with a solution of nutrients, antibiotics and oxygen that dries the tissue and cleans the passages, enabling them to work more efficiently. (Ralston calls the proprietary solution they use “magic.”)

After the three- to four-hour process, “These lungs appear the same as perfect lungs,” he said.

Researchers who studied 18,250 lung transplants from 1987 to 2010 found that 309 recipients who received a restored lung from a person who died from drowning or asphyxiation did as well as those who received other types of lungs. There was no decrease in long-term survival or organ rejection in the first year.

Dr. Bryan Whitson, a cardiothorasic surgeon, led that study and performed Ohio State's first two restored-lung transplants.

He described Kosta’s old, scarred lungs as “Rice Krispies-like.” His new lungs? “Pink angel-food cake.”

The hospital worked for more than two years putting the infrastructure in place for the perfusion procedure, Whitson said. Rats and pigs were used for practice.

Ohio State is trying to boost the profile of its transplant center. In 2009, Ohio State leaders halted the lung-transplant program because so few patients were undergoing transplants. The numbers — three in 18 months — were well below the threshold set by the Centers for Medicare and Medicaid Services.

In 2010, Ohio State hired the former president of the United Network for Organ Sharing, Dr. Robert Higgins, to lead the center. Higgins brought in Whitson.

The program was re-established in 2013. By the next year, OSU surgeons were looking at restoring damaged lungs.

Today, Dr. Ken Washburn directs the Comprehensive Transplant Center at Ohio State. He’s been in the position for six months and says the center has an aggressive strategy to increase the number of transplants.

“Something like this, it helps us be a leader in the field, helps set us apart,” Washburn said. “ This is a great opportunity for our patients in Ohio, and Ohio State to be a leader in this field of organ preservation and perfusion.”

Meanwhile, Kosta, a manager for Elano Corp. in Dayton, a maker of aerospace tubing and duct systems, is contemplating retirement as he recovers from his surgery. He said he is looking forward to simple tasks, such as walking to the mailbox and riding his motorcycle.

“I’m going to enjoy the rest of my life,” he said.

mferench@dispatch.com

@MarkFerenchik