NHS to trial lung preservation machine to boost transplant rates

A specialist machine designed to keep organs alive outside the human body could potentially rescue a significant proportion of donated lungs that currently go to waste in England and Wales. Draft guidance issued by the National Institute for Health and Care Excellence recommends that the technology be deployed across the health service for a fixed period to evaluate its overall effectiveness and value for money.

The UK currently records some of the lowest lung transplantation rates internationally. Figures published by NHS Blood and Transplant indicate that a substantial number of individuals remain on waiting lists for new lungs, including a number of children. Waiting times for adults typically extend to a year or longer, and data shows that a portion of adults awaiting an urgent transplant do not survive the wait before a suitable organ can be located.

Only a minority of all donated lungs are ultimately utilised for transplants. Organs are frequently declined due to concerns surrounding organ quality, alongside operational pressures such as theatre capacity and staffing constraints.

The device in question, known as the XVIVO perfusion system, operates by warming donated lungs to body temperature and circulating a specialised fluid that mimics blood plasma. Simultaneously, the system ventilates the lungs to simulate normal breathing patterns. This process grants medical teams the ability to monitor organ function, manage infections, clear excess fluid, and reinflate areas that have collapsed. By keeping organs viable for a notable duration, the technology could unlock numerous additional organs for individuals waiting on NHS lists.

Previously, use of the machine had been restricted to a small number of adult transplant centres, with no prior endorsement across all centres or for paediatric cases. The newly proposed guidance seeks to broaden access so that all transplant centres can utilise the equipment regardless of location or size, supported by initiatives such as NHS Blood and Transplant's Assessment and Recovery Centre pilot programme.

"Every donated lung is a precious gift, and right now too many of them never reach a patient who needs them. This technology has the potential to change that, giving transplant teams the time and information they need to make the most of organs that would otherwise go unused."

Dr Anastasia Chalkidou, healthtech programme director at Nice, via The Guardian

Dr Chalkidou noted that the recommendations align with broader initiatives to improve healthcare access, ensuring that a patient's geographical location does not dictate their ability to receive a transplant.

Evidence gathered through patient surveys conducted by Nice details the heavy toll exacted by the waiting list. Affected individuals reported remaining confined to their homes to avoid infections, abandoning work or education commitments, and depending entirely on around-the-clock family support. Carers and relatives described living in a state of constant vigilance, remaining within a short distance of transplant centres and forgoing holidays.

Jonathan Blades, head of policy at Asthma + Lung UK, pointed out that UK lung transplant rates lag behind many peer nations, while broader respiratory health outcomes remain among the poorest in Europe. He argued that transformational change requires renewed research and political commitment.

"We look forward to seeing the results of this trial, which could give more people with serious lung conditions more precious time with their loved ones. It could also reduce the number of donated lungs that currently go to waste if they are unsuitable for transplantation."

Jonathan Blades, head of policy at Asthma + Lung UK, via The Guardian

Prof Andrew Fisher of the British Transplantation Society and the Newcastle upon Tyne hospitals NHS foundation trust emphasised the necessity of gathering comprehensive data regarding the device's operational impact on transplant activity and patient access.

What to watch next

• The draft guidance remains open for public consultation until Monday 17 August 2026.
• Final guidance from Nice is scheduled for publication in October 2026.