Across the nation, only 20 percent of donor lungs are ever used for a transplant because of suitability issues. Thoracic surgeon Errol Bush wants to dramatically increase this percentage by improving donor lungs and preventing any additional decline of the lungs through the use of ex vivo lung perfusion (EVLP). In fact, he already has.

Bush recently served as a co-investigator of an international clinical trial that compared the results of transplanted lung function after EVLP as compared to cold storage, the traditional standard of care. EVLP is a technique that uses a machine to circulate blood through donor lungs before they are transplanted.

Bush found a significant reduction in the occurrence of a condition that leads to functional decline in the lungs—grade 3 primary graft dysfunction (PGD)—in patients who had transplanted lungs that were treated by EVLP. “After one year of outcomes, the incidence of PGD with the machine was superior to being on ice,” says Bush. “That’s very promising.”

In 2015, Bush came to the Johns Hopkins Department of Surgery as the director of the Advanced Lung Disease and Lung Transplant Program. With experience in EVLP, he will also serve as director of the new EVLP program and is currently collaborating with researchers, such as pulmonologist Bo Kim, to translate EVLP into clinical medicine.

Together, Bush and Kim are investigating novel therapies to use with EVLP to improve lung function and protect against additional decline. “If we can predict PGD and stop it,” says Bush, “it could mean a dramatic increase in the supply of suitable lungs for transplantation.”