The National Institute for Health and Care Excellence has issued draft guidance recommending a four-year trial of the XVIVO perfusion system across National Health Service transplant centers. The device maintains donated lungs in a viable state for up to six hours by warming them to body temperature, circulating a plasma-mimicking fluid, and providing mechanical ventilation while allowing medical teams to assess organ function and perform therapeutic interventions.
Current lung transplantation rates in the UK rank among the lowest globally. Approximately 170 patients, including six children, are on the transplant waiting list at present. The majority of adult patients face year-long waits, with some waiting two years or longer. Among those requiring urgent transplants, up to one in five die within a year while awaiting a suitable organ. Despite these needs, only 23% of donated lungs are currently utilized, as organs are declined for reasons including tissue quality, staffing constraints, and operating theater availability.
The proposed technology aims to address this disparity by enabling the rescue of four in five lungs that would otherwise be discarded. By extending the time organs remain transplantable, the system could unlock hundreds of additional organs for patients. The guidance seeks to ensure equitable access across all transplant centers, regardless of institutional size or geographic location, and to expand use to pediatric cases following previous trials at three adult centers.
Health advocacy groups and transplant specialists have responded positively to the recommendation. Officials noted that the initiative reflects broader efforts to improve patient access to transplantation services and reduce geographic disparities in transplant availability. Stakeholders emphasized the importance of generating robust evidence during the trial period to demonstrate the device’s impact on transplant activity and patient outcomes.
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