Dr. Shaf Keshavjee

The Toronto Lung Transplant Program at University Health Network (UHN) is the global leader in lung transplantation—a life-saving procedure that is standard-of-care for critically ill patients with end-stage lung disease. Since the world’s first successful lung transplant at Toronto General Hospital in 1983, our tight-knit clinical and research team has continued to translate many research breakthroughs from bench to bedside.

Despite this progress, there are far more patients in need of transplants than there are available donor lungs, resulting in long transplant waitlists, increased morbidity and mortality, and a slower road to recovery.

To address these issues, our team pioneered the Toronto EVLP system—a breakthrough technology whereby harvested donor lungs are preserved in a functional physiological state at 37°C (body temperature) and provided oxygen, nutrients, and other critical resources prior to transplantation. This enables donor lungs to “breathe” outside of the body (“ex vivo”) for up to 12 hours.

Since our first clinical trial in 2008, EVLP has evolved from a tool to preserve donor lungs into a complex diagnostic and therapeutic platform that is now the gold standard for organ assessment around the world, including in the USA, Brazil, Japan, China, Europe, and Australia.

However, the decision-making process in proceeding to transplantation is not standardized. It is difficult to interpret the wealth of information that EVLP provides in a timely manner and still requires experienced clinical judgement to consolidate the large constellation of data points.

The team is applying Artificial Intelligence (AI) during EVLP to more accurately assess donor organs for transplant and predict recipient outcomes. This project will transform how we perform organ transplantation. Our dataset of over 750 clinical EVLP cases is by far the largest in the world, ideally positioning us as the best and most capable team to lead this endeavour.

Given the global adoption of EVLP already achieved, our work is strongly positioned to have an immediate transformative impact on standardizing donor organ assessments internationally. More broadly, our work will also guide other transplant groups that are starting to develop their own Ex Vivo Organ Perfusion (EVOP) systems for the liver, kidney, pancreas, and heart.