The United Kingdom has among the lowest lung transplantation rates globally, with 170 patients currently awaiting new lungs through the NHS, including six children. Wait times typically extend to one year for most adult recipients, with some patients waiting two years or longer. A significant proportion of patients on urgent transplant lists—up to one-fifth of adults—die within a year of registration without receiving a suitable organ.
Currently, only 23% of all donated lungs are utilized for transplantation in the UK. Organs are declined for reasons beyond tissue quality, including staffing constraints and operating theatre availability. The National Institute for Health and Care Excellence has issued draft guidance recommending adoption of the XVIVO perfusion system across NHS transplant facilities. The technology is estimated to salvage four in five lungs that would otherwise remain unused by maintaining organ viability for up to six hours.
The machine functions by rewarming donated lungs to body temperature while circulating a fluid resembling blood plasma through the organ tissue and providing ventilation that replicates normal breathing patterns. This system enables transplant teams to assess organ function in real time, address infections, remove accumulated fluid, and restore collapsed lung sections. Although the device has undergone trials at three adult transplant centres, the draft guidance aims to expand access across all transplant facilities regardless of institutional size or geographic location, and would mark the first approval for pediatric applications.
Health policy officials and transplant specialists have responded positively to the recommendation. Dr. Anastasia Chalkidou, healthtech programme director at NICE, emphasized that the technology could prevent organ waste by providing transplant teams additional time and diagnostic capability. Jonathan Blades from Asthma + Lung UK noted that UK lung transplant rates lag behind other developed nations and that the technology represents progress toward addressing poor respiratory health outcomes in Europe. Medical professionals have stressed the importance of generating rigorous evidence documenting the device’s impact on transplant activity and patient access.
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