Lung Bioengineering

Hello and welcome to the Get to Life Podcast where we have conversations about organ, tissue, and ideonation and transplantation. You can always find us at thegiftedlife.org. I'm I'm Joey Boudreau. I'm Sarah Blakemore.

And on today's episode of The Gifted Life, we'll be talking about a technology that will absolutely change the donation world as we know it. And we're going to talk about if you're overthinking how to stop it. Wait, what? I'll tell you how that's all right.

All that more right here. Hang on. Here on The Gifted Life Podcast, we are so pleased to be able to speak with Brandi Zoffke. Hey Brandi.

Hey guys, thanks for having me today. Thanks for coming on. Brandi is the director of lung bioengineering and I guess we'll start with that Brandi. So what exactly is lung bioengineering?

Lung bioengineering is a company that is providing ex vivo lung perfusion to transplant programs, basically acting as an interim between taking lungs out of donor patients and being able to reassess them for suitability for transplant. So we gather all of this additional information and give it to transplant centers to make better informed decisions on whether or not they should use that particular organ in their recipient that's on the wait list. So I'll kind of just lay a little bit of the groundwork from an allocation standpoint. So in general, of course, the OPO, the LOPAs of the world, if we have a suitable donor, we evaluate every organ, right?

And we evaluate the lungs. Oftentimes, the lungs have the most or the most susceptible organs to the environment because obviously it's an open passage there and you can have pneumonia really easily and other things that take place, especially with brain death and brain injury and trauma and all those things. So from an acute standpoint, from a temporary standpoint, we see the most challenges with trying to get the lungs back to normal, back to functioning that the way that they would before. The other big thing, and I'm assuming without speaking for you, Brandi, one of the other challenges is the fact that the lungs only have four hours from blood flow to blood flow from the donor to the recipient.

So I certainly saw the need, you know, and when I saw my first ex vivo machine in person, I was like, in all, it's from being a medical guy. Yeah, sounds amazing. So can you tell us a little bit, Brandi? So what kind of, what was the biggest problem that you guys saw that needed to be solved and tell me about kind of the origins of it?

Yeah, of course. So right now in the United States, only about 20% of organ donors are lung donors, right? So that is an incredibly small percentage when you compare it to other organs, like kidneys or livers, right? So how can technology help fill the gap?

How can, and what is the reason that only 20% of these organs are being used? And you hit the nail on the head that, you know, there's clinical indications of why these lungs are much more delicate and more susceptible to injury from either resulting from the way that the donor passed away or even resulting from the mechanisms of trying to maintain life with being on prolonged ventilation. So, so one of the things that our program was aiming to do is how could we help give transplant centers information to make better decisions? So like Joey said, one of the problems is with cold is the time that after the lungs come out of the donor, there's no way to get any more information on those organs because they're cold and it's an urgent process of getting it out of one, out of the donor, putting it on ice, transporting it and getting it back into the recipient as quickly as possible.

So what if instead you could kind of take a pause and gather more information, whether it's assessing how that lung is actually performing, getting the data to be able to do that, or even just creating a pause for logistical reasons, to be able to provide flexibility back to the transplant center to be able to pull the transplant off. You know, everybody in the transplant world is well aware of the magic that happens on every single case of getting the coordination of a donor and a recipient to even happen in the first place, but you add in confounding factors like questionable quality or, you know, weather or having to coordinate around the donor hospital, the recipient hospital, etc. Those things can really impact whether or not an organ is used and utilizing ex vivo lung perfusion is a way to do that. Putting the lung on a perfusion circuit, gathering information and seeing how and allowing time essentially for that organ to declare itself as yes, I am suitable for transplant or no, I'm not.

And so how does a lung bioengineering even get started because this all so incredible? So we knew there was a need. How did you guys choose to fill it? Yeah, and I think it helps by better understanding how lung bioengineering even came to be.

So just to give you a little bit of history, lung bioengineering is a subsidiary of United Therapeutics and the president, the CEO and chair of United Therapeutics is Martin Rothblatt. And in her previous life, she was actually the founder of what is now serious XM radio. They may be saying, okay, how does that get serious exactly like how does that even happen? Well, unfortunately, Martin's daughter at a very young age was diagnosed with pulmonary arterial hypertension.

And at the time, which actually I can say was 25 years ago, we just celebrated our 25th anniversary of United Therapeutics, but it was over 25 years ago. There really weren't any medicines available for pulmonary arterial hypertension patients. And being a woman with resources, she went and sought out some medical experts and they're like, you know, there's just not a lot of options. She's going to need a lung transplant.

So she created a foundation to find a cure for PAH and the researchers essentially came back to her and were like, listen, there's a drug sitting on the shelf. But no one is going to develop it because the cost is so high and the patient population is so small. And obviously, you know, not happy with that answer. So it went back out her PhD and basically started a biotech company.

And, you know, as I mentioned, it's 25 years ago, but even more importantly, that was four FDA approved drugs that go specific to pulmonary arterial hypertension. And I'm happy to report that her daughter works for our organization and has been on our medicines and is doing extremely well. And like, have the gills, right? Yeah, yeah, it's really incredible.

And it kind of shows that I would say we're not your typical biotech company. We're very, you know, obviously, passion-driven. But even more importantly is that Martine didn't just stop there. So we now have these medicines, right?

We have these four drugs that have been buying this patient population time. But it's still not a cure. The only cure for a PAH right now is to get a lung transplant. So again, Martine, having access to amazing resources, met up with some experts and said, you know, what is it that these big lung transplant programs in the world are doing that they're being successful and they're able to utilize more organs?

And that really came back to XVable Lung Perfusion. And she's like, well, okay, well, why aren't American transplant centers using this technology? And the reality is that they were using the technology. There's multiple ways of doing XVable Lung Perfusion through different clinical trials.

There's an FDA for device now. But the feedback that she was getting is how cumbersome it is to do this for your own transplant program. It takes a lot of people. It takes a lot of extra money.

It takes a lot of oversight to be able to do this. You know, the transplant center is responsible for going and getting the organ, right? And then they have to put the organ into the recipient. So having to do this interim step would take up a lot of resources.

And so she decided to basically create a almost a new class of healthcare provider. And offer XVable Lung Perfusion to American centers without them having to lift a finger. So that's really how lung bioengineering started was trying to provide resources back to transplant programs. So they wouldn't necessarily have to do it themselves.

That lung bioengineering could support the transplant center by having these facilities with all of this additional data and be able to allow transplant centers to make better decisions for their patients. And that started, let's see here, back in 2015 is when the idea of lung bioengineering was really coming to fruition with the operation of our first facility. And just in fall of 2020, we opened our second facility. So we now have two facilities, one in Silver Spring, Maryland, our headquarters, United Therapeutic headquarters, and then we just opened our second facility down in Jacksonville, Florida.

So you talk a lot about kind of reconditioning. So how exactly does the machine work, so people can understand? Yeah. So with the technology that we use, we use an Acellular Perfusion, which means we actually do not use blood.

We use a solution called Steen Solution made by the company XVable, and use that to perfuse the organ. So in a roundabout way, the machine has a is composed of a ventilator and a perfusion circuit. So similar to like a heart lung, like a bypass circuit. So the lungs are connected via the left atrium and the pulmonary artery, and fluid, this Acellular perfuse flows into the pulmonary artery, circulates through the lungs, and then comes back out and is recycled back through the circuit.

And with this type of technology, we're actually removing the oxygen from the perfuseate. So unlike in a heart lung machine, the idea is to oxygenate the lungs while the surgery is happening because they're acting as the lung. But what we're actually doing is removing the oxygen from the perfuseate and assessing how the lung oxygenates. So we're able to see what the difference is between the perfuseate going into the lung and coming out all while the lung is ventilating.

That's amazing. So to picture this, you've got at least the one that I had seen was like basically lungs in a glass box, right? Is it still like in glass box? It's plastic.

Yeah, it looks like a plastic dome. So you've got it hooked up to a vent later. So the lungs are expanding back and forth. And then this, basically, perfuseate, like what blood would be flowing in the same areas is absorbing the oxygen and then they can test.

Then you guys can test and see how well the lungs are oxygenating, how well they were based on the oxygenation in the perfuseate. Am I right? Exactly. Exactly.

We're drawing gases on the lung as if it's like a patient. So you're really taking away. We were talking a little bit about in ICU, how lungs are susceptible. So it's whether it was an injury that resulted in confusion, or maybe it was the fact that they've been on a ventilator so long.

It could be just from neurogenic pulmonary edema as a result of the cytokine storm that happens at brain death, right? So it's taking the lung out of that environment and putting it so you don't have any of these other organ systems that you're worried about. The other problem was having been a former procurement transplant coordinator myself. One of the other problems is the delicate balance of trying to maximize the potential of the lung while not compromising the other organs.

You've got the kidney doctors who want to keep those kidneys flowing and you've got the lung doctors who will dry the patient up, dry the patient, take it off. We don't need that much fluid. So from us, as you mentioned, being a procurement coordinator, so we have to fight that. We have to try to figure out that balance and it's very challenging, especially if a patient has somewhat compromised organs and especially kidneys or lungs if they're compromised in any way, especially the kidneys.

So to be able to take it out of that environment where it's completely independent, so you don't have to worry about drawing out the kidneys where you have kidney damage because kidneys like fluid. So you don't have to worry about that. So you can dry out these lungs and focus just on that as a completely separate organ. It's not part of anything else.

I think I would be so excited if I worked honestly. That stuff excites me to see how much improvement you can make when you don't have to worry about every other organ system. For sure. And the reality is what we're doing right now is actually what I consider to be boring stuff, right?

I mean, what we're talking about right now is, you know, like, yeah, it's great. It works. You know, we're able to expand, you know, some of the thought processes and we're really in the business. I always say about changing the culture of donation and transplantation to kind of shake things up a little bit.

But what I'm excited about is really what the future of this technology will allow for with the potential for therapeutic interventions, right? What if you could actually fix the lungs? What if you could, you know, cure a pneumonia? What if you could do that?

Think about all the, you know, that 80% of lungs that currently aren't used. How impactful that could essentially be. Right. You know, so, so you kind of touched on it being on a ventilator.

Your body is not accustomed. Lungs aren't accustomed to being having forced air into them. Like you normally they work by negative pressure. So kind of passively.

And you've got this positive pressure ventilator forcing air. And so often, you know, they don't react as well. And you'll see it's a lot easier for pneumonias and stuff to sit in. And that for me, at least, I know this is kind of, you know, off the cuff.

But I would imagine that's probably our biggest battle that we see on the recovery side is pneumonia itself. Like you're in an ICU with patients around that also have many other microorganisms. And it's so easily transmitted sometimes, easier than people realize, you know, to set in. So to be able to, you know, looking into the future, to be able to fix that would be amazing.

Which is the ultimate goal, right? Is to increase the amount of lung transplants to save more lives. And I think that's really what this is doing. Exactly.

We hope that, you know, being able to do it safely. Right. That's the thing. You know, the kidney transplant and not anything against kidney transplants because they're obviously very important.

But if the kidney fails, the patient goes back on dialysis. Right. Lungs, you don't have that flexibility when the lung fails. The patient likely will not survive it.

You know, they do do repeat lung transplants, but that is, you know, from an immunologic perspective, that surgery, you know, it's a big risk. And the survival is already in general, not the best for, you know, when you're comparing it to like a kidney, for example. So this is a way that hopefully will allow, again, those transplant centers to make better decisions, better informed decisions for their patients. So how does that process work?

Does a transplant center accept donor lungs and you get involved with the pump? Or are you already in contact with transplant centers about your services? Yeah, that's actually very much how it works the majority of the time. The organ procurement organization is, you know, assessing the donor and they are electronically notifying all these transplant programs.

And the transplant program should be looking at it and saying, do I want to take this lung to transplant? If no, then should I consider using XVV lung perfusion, which I have access to through one way or another. And at that time, the transplant center, they're even thinking about using lung bioengineering. They usually just give us a call and say, hey, we're intending to take this back to transplant, but we wanted to give you a head up just so you're aware.

But there's those other situations where maybe they flew, they flew into LOPA, right? And they're in the OR because they're intending to take these direct to transplant and they opened the chest and they're like, oh my, not what I was expecting. Based on all of this information that the OPOs provided CTs, chest xerias, blood gases, all of those, you know, the eyes and nose, et cetera. This is not what I thought it was going to look like.

I'm not really excited about it, but I want to get some more information. They can actually hold a trigger at that point and infinitiate the recovery of the organ and sending it to one of our facilities at that point in time. So really anytime they're even considering it, they can trigger the referral where it's 24, 7, 365 business. And so we're there to support our transplant center partners.

It would be great, you know, knowing, understanding the allocation side, of course, as you do. It would be great. There's so many times that I know this, these are good lungs. They might have a bad story.

It might have something to it, but I know in general, like these are good lungs. Like I said, I've been working, you know, doing this for 20 years. And there are no takers, you know, for one reason or another. Yeah, so you can understand the frustration that I would have, you know, that I have on a regular basis on this.

It would be great that if we could just send them to you guys, you know, when we see when we go down the list and we're having trouble placing into sin to you guys and you guys be able to fix whatever that little nuance, that little issue is to show a little bit of improvement, whether you mentioned with the fluid, you know, maybe we've been able to do that. And so we're timing. Your timing is impeccable because though the majority of time the referrals do come in from the transplant center. We also just recently launched a way for OPOs to direct those types of lungs to our facilities for additional allocation while the lungs are in transit.

Again, we are, we're looking at ways to really shake things up. And if the OPO feels that the lung would be suitable. So there's a perfect example is a DCD, right? So family says I want my love known to be a DCD donor, but you're going to go to the OR.

Right now, you're going to get, you know, because of one reason or another and it is the OPO scramble of whatever it takes to try to make it happen. But the reality is, is to find a recipient, facilitate getting that transplant program to the donor hospital takes too much time. And so that's where a lot of opportunity dies at that very point. They don't even it's just okay we're just going to go for kidneys, right?

But what if instead you recover the organs, put them on a plane, send them to lung, you know, have them en route to lung bioengineering and then you start your album. And then you start your allocation and you're allocating water and transit. And then while the lungs are on EVLP, you have a transplant center that might be interested and it would buy the transplant center enough time, potentially to find it together a recipient in because that's the crux of this, right? For those rapid placement type situations, you know, obviously there's the whole allocation and getting the offers out, but it's also that the root that the transplant center has to have a recipient right there ready to go.

And you know, with COVID, that's not necessarily the case anymore. These patients aren't, you know, they're having to travel in because, you know, transplant centers aren't always asking them to relocate because of, you know, that because of COVID. Or they don't have the patient themselves does not have the resources to pick up and move to another city to be closer to a transplant center. Right.

Yep. So, so just for the listeners, you know, she mentioned DCD and we've spoken about the DCD in multiple podcasts, but donation at the circulatory death, you know, it's when a family is when a patient in general, it's oftentimes a patient who has has a severe brain injury or some other issue that they're requiring life support. And they no longer want to live on life support. And those are the ones, obviously, about now it's up to about 20% of the recoveries of the donations take place this way as opposed to the more traditional brain death donation donation at the brain neurological death.

So, so this happens. So the kidneys have 24 hours of no blood flow that they can survive. And we have kidney pumps that can extend that in a little bit longer. But what you mentioned was exactly what would happen if the family says you can do it, you know, recover, but we want to go now.

That's exactly what we do. We plan our team to go. We go and recover the kidneys. We put the kidneys on a pump and we allocate the kidneys only, whereas this would be a giant breakthrough.

This would be, I can see more life saved. It's more opportunity like you're saying. It's I can see a ton like it's the possibilities are endless here by having this as a resource as a possibility to be able to call you guys and say, look, we're going to recover. And, and you know, a lot of a lot of the OPOs have a recovery surgeon.

You know, it's not it's not as easily available having a thoracic along our heart surgeon available, but a lot of us in the OPO world do have heart and lung recovery surgeons. Most of the recovery surgeons that we do have are abdominal, you know, that are on call for us, but most of us still or a lot of us at least have someone that they can call in a pinch that would come and recover heart and lungs and to be able to have that and time that and call you guys and send lungs, you know, for the reconditioning and, you know, to put it on the XV O, EVLP as you mentioned, XV O lung perfusion and then start offering and finding that, you know, it just changes the whole timing. It just completely changes the game and I applaud you guys for being forward thinking for being able to put that out there. We certainly on our end will be contacting you.

I saw a head check and yes. All good information. Yes. You guys are in Florida.

It's not not a very, you know, for like for us. So to be able to have that as an option is incredible. Yeah, we're looking forward to being able to expand this. You know, I mentioned a couple of times, but we're, you know, obviously in the business of XV O lung perfusion, but what I always say our real businesses is changing cultures.

So changing the culture of transplant centers and just looking at a piece of paper, you know, looking at their donor net screen to evaluate an organ. Right. So right now they do that and I say yes or no, and then that's it. Instead, why not?

Why not take a look at it in the OR? Why not get more information to make to make those decisions? So there's that. It's also the business of, you know, interoperative declines instead of just declining it again using that as an opportunity to get more information.

But then there's this whole other part with the OPOs and, you know, back when I was a coordinator, it's been a while, but when I was a coordinator, we had, you know, this rule out plan. So, you know, you're, you go in and you're going to assess all the organs and based on X, Y, and Z criteria, you may not even run a list. So how can we empower OPOs? And one of my colleagues, Sam Poba, who gave him a little shout out, coined this phrase of turning a no into a maybe.

How do we shift the mindset on both the OPO side and the transplant center side to really think about, okay, maybe no to direct to transplant, but maybe with the O key. So how can we leverage that on both sides to create a push from the OPOs to push lungs into to the transplant centers and then the poll of getting the transplant centers to consider those organs. That's amazing. That is it is a cultural change, you know, and it's everyone changing their mindset, like you mentioned, from no to maybe.

You know, I can tell you that's what we do here. You know, this, you know, if there's, we have a very, I don't know, if aggressive is the right way, but we look at every organ as it may be, it has a bad story, but there's potential that it can benefit someone. You know, so we, you know, until pretty much the list is exhausted, you know, we're pushing on each and every organ, just in case there's that one patient, that one transplant center for that one patient, you know, that would be the perfect match in this donor, you know, would be the perfect match for that recipient, especially for that donor and for that family so that, you know, we've exhausted all of our opportunities. So thank you very much for providing us even more opportunities here.

And I completely agree with your mindset. You know, that's certainly something that we embrace here at LOPA. And hopefully we can, you know, see that spread throughout the industry. Yeah, for sure.

And let me be clear that this is not magic. This isn't a fix for all organs, you know, a consolidated infected organ is still a consolidated infected organ on the LP. You know, it's not going to fix it today. Today, things are not going to be fixed, but today it is going to give them more information without all of the confounding factors of other organ systems and, you know, just the donor in general, it's going to remove all of those and allow, you know, the lung to declare itself.

But what the future of this technology holds is what those other opportunities are. So I think that it will be magic someday. I hope that, you know, I hope that, you know, lung bioengineering gets to be part of the reason, especially with United Therapeutics has an entire division devoted to organ manufacturing. Where, so I told you a little bit about Martin's story and how she, you know, we have these medicines and we're buying patients time and now she took resources and said, how can she influence more patients getting a lung transplant when they need one, right?

But she didn't stop there either. She's like, okay, so this is still, you know, a requirement. It's still limiting the number of ultimately the number of transplants that can happen. There's 600,000 people with end stage chronic lung disease.

So what if you could manufacture the organ and take away a lot of these other issues? So we actually have multiple areas within our organization that are looking at just that. How could we actually influence all patients getting a lung transplant when they need it and not having to wait? So some really incredible things that I feel that are coming out of United Therapeutics in our future.

Well, Brandy, I know I have learned a lot here, taken lots of notes. I'm excited for the future and I'm confident that you will be back on the gifted life, right? We have so much more to pick your brain about, but thanks for your time. If people were listening and they're like, I just want to learn more.

I want to see more. How can they do that? Yeah, they can visit our website at lungbioengineering.com. And if they have questions, they can submit through there and we'll get them connected to the right people to learn more.

All right, Miss Brandy. Thanks for your time. You're so welcome. Thanks for having me.

All right, guys. It's that time. We take a moment for mental health. Yes, and this time, I don't know what to think about it because I'm always overthinking.

So I'm curious. I'm curious. How are you going to get me to stop overthinking? It's so simple, but I mean, we all do it, right?

Absolutely. I overthink a lot of stuff. I just got an email from a professor and I've been panic sweating about it for 20 minutes, but it's not a big deal. He's just checking on me.

So we're going to be talking about overthinking today and one way to phrase overthinking could be rumination, but particularly today we're going to talk about rumination. That's negative. So the things that give you anxiety because not all rumination is negative. Thinking things through is a really good thing, being process oriented, problem solving is a really good thing.

But this is more about rumination that is causing you stress, anxiety, and it's taking away from your daily activities, like going to sleep at night. Laurie and I talked a lot about that, how we do a lot of our negative overthinking that night. I'm overthinking time is when my head hits the pillow. Yes.

And sometimes it's like a conversation I'm having with someone. I say something very innocent, but did they take it the right way? Did I hurt their feelings? I hope it hurt their feelings.

Like, how can I make it better? And it very innocent, very innocent, but then it starts spiraling. Yes. And no one should feel that way.

And especially if it's getting in the way of work, sleep, your time with your family and friends. We don't want that. We don't want this negative rumination. So the first thing to do is to just recognize it.

Recognize that you're negatively ruminating on something. It can help to have a partner who helps you recognize it, but really you got to do it yourself. You have to have an internal dialogue that's saying, this isn't healthy, this isn't happy, this isn't bringing positivity and realistic conversations to mind. So you have to recognize it.

So I can't just say, actually stop overthinking it. Like that doesn't work. No, it doesn't work for you. Every wife loves to hear that.

Yeah. Everyone. Stop overthinking it. That's right.

Those are just magic words calm down and stop everything. You have to internally recognize what's negative for you. So someone pointing out for you is great, but the first step is to know yourself. This isn't helpful and it's getting in the way of a lot of things.

So I need to fix it. And you know it doesn't help sometimes social media because we had a friend who just said, Hey, here's what happened with my kid. Very innocent. And then it was parenting advice.

You should have done this boom, boom, boom, boom. And someone has been like, Why are you keeping reading the comment? Like, why wouldn't you stop that? Because it was like negative and then yeah, it would make her think, think, think, think.

Yeah. And I was like, Oh, that's horrible. Delete it. Just delete it.

Let's start over. Yeah. And when it causes, you know, you to form resentment for yourself or for others, that's not great. Yeah.

Overthinking something that's going to cause you to resent or feel angry, guilty shame, all of those things. We don't want that. We're trying to cut that out, guys. Right.

Be good human. So recognize it. Number one, recognize it in yourself. Number two, simply shift away from it.

And you can do that in two different ways. You can do a simple distraction where you read a book, go for a walk, do something creative. Take a cocktail. Have a cocktail.

Talk about something with, you know, a friend that has nothing to do with what you're ruminating about. Just shift away from it and do it in simple ways. The second we can do it is focus on problem solving. So when you are ruminating negatively, try to think of a solution to a problem because a lot of times these aren't real problems when you're ruminating negatively.

But maybe if you think of a simple solution for it, it really helps. And then you feel great. We all know that feeling when you finally solve a problem. It just relieves a lot of stress and tension.

So or something else comes up and I start on that one. This one's forgotten. Exactly. I love it.

All right. So stop overthinking. Joe, you're taking notes. I got it.

You have a topic you want to cover, email us info at the gifted life.org. Our question and answer segment today. This one's for you, Laurie. So can I donate my body to science by registering at the O and V?

So the simple answer is no, but out in the community, we are getting this question a lot. How do I donate my body to science? So in Louisiana, which if you live here, then kudos to you, right? And if you get a lopa.org, that's our website under donation facts.

There is a tab for anatomical donation. So if you click on that, they're the links to the forms that you'll need. So there's pre planning, you guys, you know, we had talked about this. You have to pre plan ahead of time.

So that's where you go if you're in Louisiana. Now, here outside of Louisiana, we recommend that your contact your organ procurement organization. They can help direct you to the centers that you need to turn to for that to ask more in detail. All right, guys, if you'll have a question for us, give us a call at 504648347.

In every episode of the gifted life, we honor a hero. Today's hero is Sheila Fields-Dupar. And we learn about Sheila from her family. My mother was always the light that shine bright in our family.

And on the day she was hospitalized in 2019, I didn't know the last time I saw her drive away with the sun shining bright that our lives would change forever. In March of 2019, my mother passed away and she was an organ donor. We have received many letters and cards from the different families that have been helped by my mother choosing the gift of life upon her passing. May God bless each and every family that has suffered a loss and those that have been held on the other side of that loss.

And now we pause and say thank you to Sheila for the gift of life. And that'll do it for episode 167 of the Gifted Life. Thanks for listening, everyone. And remember, you can register as an organ tissue or eye donor anytime, register me.org.

Very special. Thanks for brandy, Zofki for discussing lung bioengineering and just the sheer impact that it can have. That has been having on donation and, of course, the potential that it can in the future. I love it.

The best place to find us guys is at our website, thegiftedlife.org. You can listen to all of our episodes there or anywhere you like to listen, whether it's Apple, Google, Spotify or iHeartRadio. If you do listen on Apple Podcast, please give us a five star rating review and let us know how you like the show. It really helps others find our podcast.

And if you're on social media, you can like our page on Facebook. It's the Gifted Life podcast. You can follow us on both Twitter and Instagram at Gifted LifePod. We really appreciate you listening and we hope that you go out and do something you would normally do to help us make life happen.

We are all one big team. This is a production of LOPA, or the Louisiana Organ Procurement Agency. The Gifted Life is hosted by Lori Steele, Joey Buudro and Sarah Blakemore, our executive producer at Kirsten Heins, producer is Shalom Caraway. Intern is Rebecca Rannam and we are recorded, engineered and mixed in our Covington, Louisiana studio by Troy Perez.