Dr. Egan, a surgeon in the UNC Division of Cardiothoracic Surgery, is internationally known for his research on lung transplantation, which has been under way since he came to UNC in 1989 to start its lung transplant program.
His new grant was awarded under the NHLBI’s Translational Research Implementation Program (TRIP), a two-stage program designed to translate fundamental research ideas into proof-of-concept efficacy testing in patients. This Stage 1 grant is supported by the American Recovery & Reinvestment Act (ARRA) Grand Opportunities (GO) grants program, for large-scale research projects that the National Institutes of Health says have “a high likelihood of enabling growth and investment in biomedical research and development, public health, and health care delivery.” NHLBI is part of the National Institutes of Health.
Dr. Egan’s project will perfect a technique to perfuse and ventilate human lungs outside the body (ex vivo) to determine if they are suitable for transplant, and will demonstrate safety of transplanting human lungs after ex-vivo perfusion in a pilot clinical study.
Dr. Egan’s research has focused on use of lungs from non-heart-beating donors (patients who have died of sudden cardiac arrest outside the hospital or in the emergency room) for lung transplantation. Using animal models, Dr. Egan was the first scientist to show that lungs could be retrieved from non-heart-beating donors after death and safely transplanted. His research has shown that lungs are viable after circulation stops, because lung cells do not rely on perfusion (circulation of blood or other fluids) for cellular respiration.
A conventional transplant uses an organ from a donor who has been declared brain dead and has been kept on mechanical ventilation until circulation is stopped just before organs are donated. During transplant, the stopping and restarting of circulation to the lungs can cause ischemia-reperfusion injury, which damages cells in the lung and leads to problems with lung function after transplant. Dr. Egan has designed an ex-vivo perfusion and ventilation circuit in which lungs are placed for evaluation and possible treatment before transplant.
Dr. Egan’s project will also plan a large multi-center clinical trial to use the ex-vivo lung perfusion/ventilation system to evaluate human lungs retrieved after death from non-heart- beating donors. Widespread use of lungs retrieved from non-heart-beating donors followed by ex-vivo assessment could provide much larger numbers of human lungs for transplant that may function better and last longer than lungs currently being transplanted from conventional brain-dead organ donors.
Investigators for his project, entitled “Ex-vivo perfusion and ventilation of lungs to assess transplant suitability,” are:
- Thomas M. Egan, M.D., M.Sc., Professor, Division of Cardiothoracic Surgery, UNC Department of Surgery (Principal Investigator), UNC School of Medicine
- Peadar G. Noone, M.D., Associate Professor, Division of Pulmonary and Critical Care Medicine, UNC Department of Medicine, UNC School of Medicine
- Paul Stewart, Ph.D., Research Associate Professor, Department of Biostatistics, UNC Gillings School of Global Public Health
- Eileen Burker, Ph.D., CRC, Associate Professor, Division of Rehabilitation Counseling and Psychology, Department of Allied Health Sciences, and Adjunct Associate Professor, Department of Psychiatry, UNC School of Medicine
- Benjamin E. Haithcock, M.D., Assistant Professor, Division of Cardiothoracic Surgery, UNC Department of Surgery, UNC School of Medicine
- William K. Funkhouser, M.D., Ph.D., Professor, Department of Pathology and Lab Medicine, UNC School of Medicine
- Katherine Birchard, M.D., Assistant Professor, Department of Radiology, UNC School of Medicine
- R. Duane Davis, M.D., Ph.D., Professor, Division of Cardiothoracic Surgery, Department of Surgery, Duke University School of Medicine