BACKGROUND: Right now, more than 2,700 people in the United States are waiting for a donor lung to keep them alive. Many of them will die waiting for one. A lung transplant is a life-saving treatment for people with lung failure, and it's usually a last resort. Lung failure can be a result of lung diseases like emphysema, pulmonary fibrosis and pulmonary hypertension. Tom Waddell, M.D., Ph.D., from Toronto General Hospital, says, "The problem, in general, is like for all organ transplants, that there aren't enough donors to go around. For lung transplant patients, there are very few options if they are progressively going downhill. If the donor isn't available for them, they ultimately will die of their lung disease before they can have a transplant."

THE NOVALUNG: To keep patients alive long enough to receive the lung transplant they need, some researchers are now turning to an innovative device called the Novalung. The Novalung is a new external artificial lung that uses the heart's pumping ability to keep it working. It is an interventional lung assist device and is the size and shape of about three stacked CD cases. It is a membrane ventilator that allows for oxygen and carbon dioxide gas exchange to occur by diffusion. A tube attached to the device carries blood from the patient, filters it through an oxygenator to pick up oxygen, and then delivers that oxygen-rich blood back to the patient through a second tube connected to the femoral vein. The device does the work of the lungs until a patient can receive donor lungs.

Dr. Waddell says, "It doesn't require the use of a mechanical pump. That is the truly unique thing about it. The blood pressure to drive the blood across the Novalung can actually be generated by the patient's own heart."

UNDER STUDY: The Novalung is currently under study at various institutions across the world. To date, it has been used in more than 1,200 patients in Europe as a bridge to lung transplantation. Eight patients in Toronto have already used the Novalung. Researchers in Toronto expect to collaborate with various universities in the United States in future trials of the Novalung. It is already helping some Americans stationed on the battlefields in Iraq. A recent case study was released detailing how the Novalung was used on a U.S. soldier who was wounded in battle. The report reads:

The authors describe a new extracorporeal pumpless interventional lung assistance system (iLA) which was inserted in a young U.S. soldier suffering from severe acute respiratory distress syndrome with critical hypoxemia/hypercapnia after blast injury in Baghdad. The system is characterized by a new membrane gas exchange system with optimized blood flow which is integrated in an arterial-venous bypass established by cannulation of the femoral artery and vein. After implementation of the system, gas exchange improved rapidly, and the patient was airlifted from Iraq to Regensburg University Hospital, where he recovered gradually. The system was removed after 15 days, and the patient was successfully weaned from mechanical ventilation.

Authors of that case study say, "[The Novalung] serves as an enabling device for artificial lung assistance with easy use and low cost."