The UK has been identified as having one of the lowest lung transplantation rates globally, with 170 patients, including six children, currently awaiting transplants. Wait times for adult recipients typically extend to one year, with some patients waiting two years or longer. Data indicates that approximately one-fifth of adults on urgent transplant lists die within a year of registration before receiving suitable organs.
Only 23% of donated lungs are currently utilized in the UK, with organs frequently declined for reasons beyond quality concerns, including staffing constraints and operating theatre capacity limitations. The National Institute for Health and Care Excellence has issued draft guidance recommending a four-year assessment period for the XVIVO perfusion system within the NHS. The organization estimates the technology could enable the recovery of four in five lungs that are presently discarded, potentially unlocking hundreds of organs for transplantation.
The XVIVO perfusion system functions by warming donated lungs to body temperature while circulating a fluid that replicates blood plasma through them. The machine simultaneously ventilates the organs to simulate normal breathing patterns. This process enables transplant teams to evaluate organ function, manage infections, remove accumulated fluid, and re-expand collapsed sections. The device extends the viability window for donor lungs to approximately six hours.
Although the system has undergone trials at three adult transplant centers, the new guidance marks the first time Nice has endorsed the technology for broader implementation across all transplant centers and has approved its use in pediatric cases. Officials stated that the recommendation aims to provide equitable access to the technology regardless of facility size or geographic location.
Organizations including Asthma + Lung UK and the British Transplantation Society have emphasized the importance of generating robust evidence regarding the device’s impact on transplant activity and outcomes for patients awaiting organs.
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