The UK has among the lowest lung transplantation rates globally, with 170 patients currently waiting for new lungs, according to NHS Blood and Transplant data. Most adult patients wait approximately one year for a transplant, while some wait two years or longer. Up to one-fifth of adults on urgent transplant lists die within a year of registration before receiving a suitable organ.
Currently, only 23% of donated lungs are utilized for transplantation. Organs are declined for various reasons beyond quality concerns, including staffing constraints and operating theatre availability. The National Institute for Health and Care Excellence has issued draft guidance recommending implementation of the XVIVO perfusion system across NHS transplant centers for a four-year evaluation period. The organization estimates the technology could enable recovery of four in five lungs that would otherwise remain unused.
The machine maintains donated lungs at body temperature while circulating a fluid resembling blood plasma through them and providing ventilation that mimics natural breathing. This process allows transplant teams to assess lung function, address infections, remove excess fluid, and reinflate collapsed tissue sections. While three adult transplant centers have tested the system, the draft guidance represents the first recommendation for broader implementation across all transplant facilities and marks the first endorsement for pediatric applications.
Healthcare and transplant professionals have responded positively to the development. Dr Anastasia Chalkidou, healthtech programme director at Nice, stated the technology could increase lung availability for transplantation. Jonathan Blades of Asthma + Lung UK characterized the system as an important advancement toward addressing the UK’s below-average lung transplant activity. Prof Andrew Fisher from Newcastle upon Tyne hospitals emphasized the importance of generating robust evidence regarding the device’s impact on transplant outcomes and patient access.
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