NHS Lung Transplant First Uses Lung-in-a-Box to Save Patient A British man has become the first NHS patient to receive a lung transplant using lungs kept alive in a lung-in-a-box machine, a breakthrough that could save up to 750 lives a year. A 62-year-old British man has become the first patient to benefit from a pioneering NHS lung transplant programme that could save up to 750 lives a year. Joe McConnell, a carpenter from Newport, South Wales, received donor lungs that might ordinarily have been rejected because of their condition, in an operation carried out at the Queen Elizabeth Hospital in Birmingham. The lungs were kept alive and breathing in a specially designed machine while being transported between three hospitals, allowing doctors to monitor their function and improve the chances of a successful transplant.Lung-in-a-Box Transplant Sets RecordsRoyal Papworth Hospital in Cambridge, the specialist heart and lung hospital at the centre of the pilot study, said the procedure was the furthest perfused lungs have ever travelled for transplantation outside North America, creating a new UK and European record.Many lungs offered for donation are currently rejected before being removed because they fall into a clinical grey area where specialists cannot be certain they will be suitable for seriously ill patients. Those that are removed are packed in ice for transport, but because lungs are so delicate, a significant proportion are rejected after inspection.This regularly causes life-saving transplant operations to be cancelled at the last minute. Around 17 per cent of people on the lung transplant list die every year while waiting for an organ.How Machine Perfusion Assessment WorksThe pilot programme allows lungs to be transported in the lung-in-a-box machine to Papworth, where they can be pumped with oxygenated blood and nutrients and tested further over 12 hours to confirm they are functioning properly and suitable for transplant.This means lungs that may have been turned down for being borderline or difficult to assess can be rejuvenated for use, raising hope for the hundreds of patients waiting on the transplant list.The technique used in the NHS pilot, known as ex vivo machine perfusion, has previously been used in UK hospitals and has helped organs including hearts, kidneys, lungs and livers to be assessed before transplantation. Fifteen hospitals in England, including Papworth, are equipped with perfusion machines that mimic the environment of the human body and allow organs to continue functioning.More than half of all lungs assessed in this way are transplanted, double the number placed on ice. The pilot goes one step further by keeping lungs alive while being transported around the country and introducing an extra assessment stage at Papworth.Last year, just 154 of 748 donors whose lungs were offered ultimately had them transplanted, about 21 per cent. Most organs are rejected before being removed from the donor.Patient Recovery After Landmark SurgeryIn Joe McConnell's case, the organ was donated at a hospital in the North of England and then taken to Papworth in one of the perfusion machines. The warm, high-tech chamber connects the lungs to a ventilator and pumps them with a nutrient-rich, blood-like solution that keeps them functioning outside the body.The organ underwent detailed assessment at Papworth before being sent to Queen Elizabeth Hospital in Birmingham for the operation. By the time Joe received his transplant, the lungs had been given the green light and were in near-perfect condition despite having travelled hundreds of miles.Joe, a father of two, had been diagnosed with idiopathic pulmonary fibrosis, a potentially fatal condition that causes scarring of the lungs, and would have died without the operation. He had previously been called to the hospital seven times when potential donor lungs became available, but on each occasion the transplant could not proceed until the call came in August that changed his life.Speaking ten weeks after the surgery, he said he was dying before the operation and relied on an oxygen tank to stay alive. He described himself as grey, blue and down, and said everyone who knew him could see it. He added that people now tell him how well he looks and that, compared with ten weeks ago, he is a different person.Joe said patients do not know whether they will wake up from such an operation, but he was surrounded by positive people who put him at ease.