Out-of-body experience
Drs. Shaf Keshavjee and Marcelo Cypel

​Drs. Shaf Keshavjee and Marcelo Cypel with the Ex Vivo System, their transplant-altering invention.

How UHN’s doctors invented a revolutionary way to repair and transplant damaged donor organs

Picture this: inside Toronto General Hospital is an operating room that looks just like any other, except no patient will ever be wheeled into it for surgery. The space is filled with organs – livers, lungs, hearts, kidneys, pancreases – living in a plethora of strange-looking devices, which repair and regenerate these body parts so they can be used for transplants. Surgeons might walk into the room, grab an organ and walk out the same way they’d choose other surgical instruments or supplies.

While the room doesn’t yet exist, there is a smaller version in OR 11 at Toronto General Hospital, where lungs are kept alive and breathing, and are treated ex vivo – outside one’s body – before being transplanted into a patient. The key piece of equipment in this OR is a dome-like device where damaged donor lungs, ones that would be unsuitable for transplantation under normal circumstances, get treated, fixed and made usable again. While a lot of medical devices are heralded as breakthrough technologies, the Toronto Ex Vivo Lung Perfusion System, as it’s called, really can make a difference as to whether someone lives or dies.

Centuries of innovation

The quest to build an Ex Vivo-like machine has been going on for hundreds of years – in the 15th century, Leonardo da Vinci made drawings of organs living on external support systems. In the 1930s, aviator Charles Lindbergh and surgeon Alexis Carrel tried to create a perfusion pump, a device that would keep organs functioning outside the body. But it was a team of Toronto General doctors who finally did what many thought was impossible.

In 2008, Dr. Shaf Keshavjee, now Surgeon-in-Chief of the Sprott Department of Surgery, and Dr. Marcelo Cypel, now Surgical Director of the Soham & Shaila Ajmera Family Transplant Centre at University Health Network (UHN) and head of transplant surgery within the Sprott Department of Surgery, built a device and developed a method that could keep lungs alive for up to 24 hours after they had been removed from a donor’s body without needing any blood to run through the organ.