Through ongoing research, the Advanced Pulmonary Failure and Lung Transplantation Program at Montefiore Einstein is advancing lung care, from researching new medications in the treatment of advanced fibrotic lung disease to real-world assessment of donor lung transport
technology.

The Advanced Pulmonary Failure and Lung Transplantation Program at Montefiore Einstein is conducting multiple studies to improve outcomes in advanced fibrotic lung disease and lung transplantation.

In aggregate, this research may, across patient populations, reduce the need for lung transplant, broaden access to donor lungs, and ultimately prolong lifespan and improve outcomes.

Through these different research studies, the Advanced Pulmonary Failure and Lung Transplantation Program is exploring medications for improving lung capacity for those with advanced fibrotic lung disease, and evaluating and engaging in advances in donor organ transportation and storage.

Investigating advances in fibrotic lung disease treatment

With three active pharmaceutical trials for the treatment of advanced fibrotic lung disease, Ali Y. Mansour, MD, Medical Director, Montefiore Einstein Advanced Pulmonary Failure and Lung Transplantation Program and Assistant Professor, Albert Einstein College of Medicine, is investigating different modalities of approaching the treatment of lung fibrosis. The nature of these trials represents a significant shift in the treatment approach.

Prior approved modalities focused on slowing the progression of disease. These trials are investigating leading-edge medications that instead focus on targeting pathways to reverse the fibrosis, breaking down ongoing scarring as well as scarring that was already present before
treatment.

“We are trying newer therapies in an effort to improve lung function—not only to preserve it, but to gain what has been lost,” said Dr. Mansour.

Current FDA-approved medications only slow the progression of lung fibrosis. These new therapies hold promise to stop progression of the disease, improving lung function, and reversing lung loss that has occurred, avoiding the need for lung transplant.

In some cases, transplantation may become necessary for a patient's treatment. The Advanced Pulmonary Failure and Lung Transplantation Program’s continued research and integration of innovative technology offer new opportunities for patients who have exhausted other treatment
options.


Evaluating state-of-the-art donor lung procurement and transportation

The LUNGguard™ Donor Lung Preservation System is a recent innovation in the procurement, transportation and monitoring of donor lungs. As an early adopter of this emerging technology, and one of only two hospitals in New York City using the LUNGguard system, Montefiore Einstein is a national leader in advancing donor lung procurement. Real-world data on the utilization of this technology is now being collected and compiled in the GUARDIAN-Lung Registry.

Montefiore Einstein is one of only 11 large academic centers in the nation, and the only health care system in New York, taking part in the GUARDIAN-Lung Registry. The collection of this vital data is essential in evaluating the best practice of the device’s use in procuring and
transporting donor organs.

Stephen J. Forest, MD, Surgical Director, Montefiore Einstein Advanced Pulmonary Failure and Lung Transplantation Program and Associate Professor, Albert Einstein College of Medicine, is the institutional Principal Investigator for the GUARDIAN-Lung Registry. He was also one of the first to use the LUNGguard system at Montefiore Einstein’s Comprehensive Lung Program.

“Now we’re contributing to supporting the device, collecting important data on real-world usage,” said Dr. Forest. “It is exciting that we are contributing to pooled data that will help evaluate the best practice of how we can procure and harvest donor organs, extend our criteria, our geography and our ischemia times to benefit our recipients.”

The post-market observational registry collects data of adult and pediatric lung transplant recipient patients whose donor lung was preserved and transported using the LUNGguard technology or standard of care ice cold storage methods. This registry helps to better evaluate the impact this leading-edge technology is having when it comes to the criteria, geography and ischemic times of donor lungs. The technology may prolong the amount of time the organ can be outside the body, with similar outcomes.

While data collection is still under way, results from the GUARDIAN-Lung Registry from August 2018 through January 2024 observed a numerical reduction in primary graft dysfunction at 72 hours in the LUNGguard group.

Providing care to one of the most nation’s diverse populations

The population in the Bronx is one of the most diverse in the U.S., with socioeconomic, racial and ethnic drivers of disparities that may contribute to delayed patient care. Montefiore Einstein serves some of the sickest lung transplant patients in New York City, with some of the highest acuity lung transplant patients based on Scientific Registry of Transplant Recipients (SRTR) data.

Through ongoing research, the Advanced Pulmonary Failure and Lung Transplantation Program at Montefiore Einstein is dedicated to improving care for its patients and to advancing state-of- the-art care in the nation. With the most recently published SRTR data from July 2024, Montefiore Einstein continues to demonstrate exceptional outcomes with one-year patient survival exceeding expected outcomes and superior to the national average.