End-stage lung disease

Various acute and chronic pulmonary diseases lead ultimately to lung failure (endstage lung disease, ELD). When all other options have been exhausted and the patient is beyond treatment, two possibilities remain: extracorporeal lung membrane oxygenation (ECMO) and lung transplantation (LTx). If there is chronic damage, LTx remains the only therapy available.

LTx is, however, a valid option for only a limited number of patients. Furthermore, rejection reactions play a decisive role in the long-term survival of these patients.

ECMO on the other hand is still used only for short-term applications, primarily as a bridge to the ultimate lung transplantation and to improve acute pulmonary infection diseases (e.g. H1N1). Regenerative therapies are not available. Research in this field is thus of the utmost importance.

Research projects at BREATH

Research in the field of endstage lung disease (ELD) is one of the main topics at the MHH. The polyclinic has approx. 10.000 patient contacts per year and more than 1.000 of these patients are treated for endstage lung diseases, including ECMO.

One of the main areas of research is the medical complications occurring after lung transplantation (Post-Tx). Here, bronchiolitis obliterans and various other infections are of importance. Clinical research is complemented by targeted basic research (e.g. biological infections, leukocyte transport in the lung, identification of antimicrobial defense mechanisms in animal experiments). BREATH research in the field of immunology after lung transplantation is carried out using a unique extensive lung transplantation animal model on minipigs. This was specially developed for the protocolled study of transplantation tolerance.

Basic researchers at the MHH also have a great interest in the development of innovative strategies for lung regeneration and lung reconstruction, which includes stem cell research and, for example, tissue engineering procedures. In addition, the scientists have many years’ experience in adult and embryonal stem cell research (ES). Among other things, they have paved the way for the isolation of human pluripotent stem cells (iPS) from cord blood.

At BREATH, experimental and clinical research in the field of ELD is complemented by health services research and health management, which set out to perform special analyses with regard to management plans for different diseases in clinical practice.