NICE backs four-year NHS evaluation of donated-lung perfusion system
NICE has issued draft guidance recommending a four-year NHS evaluation of the XVIVO perfusion system for donated lungs. The system keeps lungs functioning outside the body so teams can monitor them and, in some cases, treat infection, remove fluid or reinflate collapsed areas before deciding on transplantation. NICE estimates it could help recover four in five donated lungs that are currently unused, though the estimate and value for money require evaluation.
The story
The National Institute for Health and Care Excellence (NICE) has published draft guidance recommending that the NHS use the XVIVO perfusion system for four years while assessing its effectiveness and value for money. The system is intended to keep donated lungs viable outside the body before transplant surgery. It warms an organ to body temperature, circulates a fluid designed to mimic blood plasma and ventilates the lungs; teams can then observe function and may treat infection, drain excess fluid or reinflate collapsed sections. NICE estimates that the approach could help rescue four in five donated lungs that are currently unused, potentially making hundreds more organs available for transplantation. The proposal follows trials at three adult transplant centres. Under the draft guidance, the technology would be assessed across NHS transplant services, including paediatric cases, rather than being limited to those earlier adult-centre trials. The development addresses a constrained supply of usable lungs. The report cites NHS Blood and Transplant figures showing that 170 people in the UK, including six children, are waiting for lungs, while only 23% of donated lungs are used. NICE says the proposed approach is intended to make access less dependent on where a patient is treated.
Why it matters
Lung transplantation depends not only on donation but on whether a lung can be safely assessed and preserved in time for surgery. The reported 23% use rate means many donated lungs do not reach recipients, while some patients wait years and some urgent-list patients die before a suitable organ is found. By allowing teams to inspect and potentially improve borderline organs outside the body, the system could change the practical decision point from immediate rejection to a monitored assessment. Its possible benefit therefore lies in increasing usable supply, not in creating new donations.
Evidence and context
The UK has one of the poorest lung-transplantation rates internationally, according to the report. NHS Blood and Transplant figures cited in the article put 170 people, including six children, on the UK waiting list for lungs; most adults wait about a year and some wait at least two years. Only 23% of donated lungs are used. The draft guidance also responds to variation in access: NICE says its aim is for transplant centres to benefit from the technology regardless of their size or location.
Limits and unknowns
The recommendation is draft guidance rather than a final, permanent NHS adoption decision. The XVIVO system has been trialled at three adult transplant centres, but NICE had not previously endorsed it for all transplant centres or for paediatric cases. Its effect on transplant activity, timely patient access and value for money still needs robust evidence during the proposed four-year period. The technology can assess and treat certain problems in donated lungs, but it cannot address every reason organs go unused, including staffing and theatre-capacity constraints.
Follow the story
Share it, watch the explainer, or continue with the reporting trail.
NICE backs four-year NHS evaluation of donated-lung perfusion system
A short visual explainer for readers who want the story in a different rhythm.
Highlights
- NICE backs NHS trial of lung perfusion system
- Lungs kept viable outside the body
- Potential to increase usable lungs from 23% to 80%
- Trial expanded to all NHS transplant centers including pediatric cases
Transcript
NICE recommends a four-year NHS trial of the XVIVO system to preserve donated lungs for transplant.
The system keeps lungs functioning outside the body, allowing teams to monitor and treat them before transplant.
Currently, only 23% of donated lungs are used; this system could help rescue up to 80% of unused lungs.
The evaluation will include adult and pediatric transplant centers across the NHS, expanding access to the technology.
If successful, more patients could receive timely lung transplants, reducing wait times and improving outcomes.