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Lung patients die for lack of organs healthy enough for donation. The project will create a centralized Danish-Swedish "revitalizing facility" for damaged lungs – the first in Europe.

Lung transplantation is the only treatment for patients with severe lung disease, but the organs are not enough, resulting in patients dying while waiting for organs. Increasing the number of donations does not solve the problem - shortage of organs - because many donated lungs are damaged and therefore cannot be used.

The ex vivo lung perfusion (EVLP) method is used clinically to rehabilitate damaged lungs and it increases the number of transplants. By centralizing EVLP from many centers into a single facility, efficiency increases significantly, but requires a larger number of lungs. Therefore, the Interreg project will create the first centralized EVLP facility in Europe. It will coordinate lungs from Sweden and Denmark, for EVLP. The center will be located at Rigshospitalet in Copenhagen, because there is infrastructure and expertise that Sweden currently lacks.

Rigshospitalet, Skåne University Hospital (SUS) and medical technology company XVIVO will design an EVLP training program to train staff in Denmark and Sweden. After the centralization of EVLP between Sweden and Denmark, the operation will be expanded to include all transplant clinics in Scandinavia.

X-ray of lungs
Illustration of lungs

New treatments

But EVLP cannot improve all lungs, especially those with lung damage. Therefore, it is necessary to develop new treatment options in parallel with the introduction of a centralized EVLP facility. Promising research from SUS has shown that therapies based on mesenchymal stem cells (MSC), a type of Advanced Therapy Medicinal Products (ATMPs), can restore the function of damaged lungs so that these can be used for transplantation. SUS has developed models for developing and effectively testing therapies, which Rigshospitalet lacks.

To facilitate this, the project will create a cross-border centralized development and testing process for therapies, in models developed at SUS. The project will also test these therapies at the EVLP facility. This will facilitate innovation in therapies for lung transplantation in Sweden and Denmark and make it possible to introduce the therapies effectively into clinical practice.

Work for equal treatment

To ensure that the project's efforts to increase the number of donated lungs for transplantation benefit the patients who need it most, it will also work to improve equality and non-discrimination. The current lung transplant process is complex and consists of several steps that can discriminate against immigrants who do not speak Swedish or Danish and cannot easily navigate the system. Not all doctors are aware of lung transplantation as an option, placing a heavy burden on patients to advocate and affecting groups that already face discrimination in healthcare, such as people of color and women.

The Bridge - Lungs for life will, together with clinics, patient representatives and the organization Mer Organdonation, develop a strategy for the training of primary care doctors, medicine and pulmonologists at small as well as large hospitals. It should be about which patients can be helped by a lung transplant. Guidelines for clinical referral processes should also be drawn up to reduce the burden of bringing one's own case, as well as remove barriers to transplantation.

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