HEALTHCARE

Mayo Clinic in Jacksonville to create lung restoration center

Charlie Patton
PROVIDED BY MAYO CLINIC - 8/11/14 - William Rupp is retiring at the end of the year as CEO of Mayo in Jacksonville. He'll be replaced by Gianrico Farrugia (pictured).

In 2014, the number of people on the waiting list for a lung transplant in the U.S. outnumbered the number of donor lungs available by about 650.

The Mayo Clinic in Jacksonville and United Therapeutics Corp., a biotechnology company, are collaborating now on the creation of a lung restoration center on Mayo's Jacksonville campus that should ultimately double the number of lungs available for transplant in the U.S.

"This is a big deal," said Gianrico Farrugia, chief executive officer of Mayo in Jacksonville. "… This is not Mayo or United Therapeutics benefiting. This is the whole country benefiting."

In 2014, 2,584 people waited for lung transplants. Only 1,925 received transplanted lungs. The 2,584 on the list were just the tip of the iceberg.

"We don't put people on the list unless they are on death's door," said Thomas Gonwa, Mayo's chairman of the department of transplantation in Jacksonville.

"The actual number of people who die of end-stage lung disease is huge," said Martine Rothblatt, chairman and co-chief executive of United Therapeutics Corp., who put the number at about 250,000 each year.

One big problem for those waiting for lung transplant is that four out of every five lungs harvested from willing donors are considered "marginal" because they are filled with fluid, including mucus blocking the bronchi, a lung's airways.

Last year, about 8,600 people who agreed to be organ donors died, Gonwa said. Only 1,925 had lungs that were considered acceptable for transplant. By contrast 11,000 kidneys were harvested and transplanted from the 8,600 donors.

But United Therapeutics has acquired the ex-vivo lung perfusion technology, which can treat those "marginal" donor lungs with specialized solutions and gases that can reverse lung injury and remove excess fluids in the organ, making them clinically viable for transplant.

When the new lung restoration center is built on Mayo's Jacksonville campus - it is scheduled to open in 2017 - and is fully up to speed, Rothblatt anticipates it will restore about 2,000 marginal lungs a year.

In addition to increasing the number of lungs available for transplant, the ex-vivo lung perfusion technology will extend the time that a lung can be viable between harvest and transplant, Rothblatt said.

The accepted time span from harvest to transplant currently is no more than 10 hours, she said.

For lungs being restored at Mayo, the time span will now be 24 hours, 10 hours to reach the lung restoration center, four hours of lung restoration, and another 10 hours until transplant, Rothblatt said.

"It provides an immense amount of time for what previously was a tightrope walk," Farrugia said.

The surgeons who harvest the lungs will make the decisions on which ones should undergo restoration.

The lungs will then be shipped to Jacksonville and undergo restoration. Then most will be shipped to whichever transplant center has a transplant candidate who is a good match, though some will remain in Jacksonville for transplant to area people on the waiting list.

With 2,000 more lungs available, not only will there be enough donor lungs for everyone on the waiting list, but the waiting list can be expanded, Rothblatt said.

Under the agreement between the Mayo Clinic and United Therapeutics, a United Therapeutics subsidiary will lease land on Mayo's Jacksonville campus to build a three-story, 75,000-square-foot building, which will house the lung restoration center. Mayo will provide physician oversight and will procure and deliver lungs to the center in coordination with lung procurement organizations.

Mayo and United Therapeutics will also work together on research on regenerative medicine, which Gonwa has called "the cutting-edge medicine of the 21st century."

The new building will be carbon neutral and environmentally friendly, with solar panels to provide energy and geothermal heat recovery for the air conditioning.

While Jacksonville will be the site of the first lung restoration center in the United States, United Therapeutics could eventually build similar centers at the Mayo campuses in Rochester, Minn., and Scottsdale, Ariz.

That could ultimately result in another 4,000 lungs being available for transplant.

"That would mean that 75 percent of discarded lungs would be salvaged," Rothblatt said.

Mayo Clinic established its lung transplant program in Jacksonville in 2001.

The program has resulted in 469 lung transplants and eight heart-lung transplants. The program's one-year survival rate is 93 percent, exceeding the national average by five percent.

Charlie Patton: (904) 359-4413