Thomas Egan, MD, MSc, is a Professor of Surgery, whose work at UNC began in 1989. His professional interests both clinical and in research have been in the area of Ischemia-reperfusion injury, lung transplantation, lung transplantation from non-heart-beating donors, ex-vivo lung perfusion/ventilation, and cell culture models of ischemia-reperfusion injury. Dr. Egan and his lab has received multiple funding from federal and foundation sources, incl. NIH, DOD, the Cystic Fibrosis Foundation and others.
New NIH R21 funding
In response to Opportunity Announcement: NOT-HL-21-024 Bold New Bioengineering Research for Heart, Lung, Blood and Sleep Disorders and Diseases, Dr. Tom Egan, Professor of Surgery, and Dr. Juliane Nguyen, Professor and Vice Chair of Pharmacoengineering at the UNC Eshelman School of Pharmacy were awarded 1R21HL178129-01: Novel innovative ultra-elastic and instantly adhesive hydrogel patches to prevent air leak after lung surgery, from the National Heart Lung and Blood Institute (NHLBI). Budget: $421,067. Study duration: 2/1/25-1/31/27.
Air leak after lung surgery is the bane of existence for thoracic surgeons and patients. Air leaks arise from 3 sources after lung surgery: through a staple line placed across lung tissue as part of lung resection, air leaking from a lung surface opened to separate incomplete fissures to remove a lobe; and Injury to lung tissue unrelated to a lung resection. Air leak after lung surgery requires a chest tube, prolongs hospitalization, increases cost and death rate, and decreases quality of life (QOL). We propose a way to eliminate air leaks after lung resection, to facilitate early ambulation, reduce pain, prevent chest tubes, and improve QOL after lung resection. We developed anisotropic and auxetic hydrogel patches (PAAx) that can be placed adherent to the lung surface and stretch with lung movement. Therapeutics can be applied to lung surfaces on both sides of these patches. We showed in rats that air leaks from ventilated perforated lung tissue can be sealed by application of fibrinogen to the side of the PAAx applied to the lung, then thrombin applied on the opposite side of the patch. This combination allows fibrin to seal the holes in the lung and helps hold the patch in place, preventing air leak under positive pressure ventilation, even if tidal volume is increased to 15 ml/kg. We will test the hypothesis that these PAAx when applied to the surface of lungs in rats with perforations and lung resections, and in pigs after multiple wedge resections and non-anatomic lung resections will have air leaks stopped so that a chest tube will not be required after lung surgery. See Figure. Many patients have air leaks after lung resection. Some are discharged home with chest drainage systems. These novel hydrogel patches with FDA-approved therapeutics (F&T) may provide an innovative solution to a vexing clinical problem.
Left: Injury to lung surface using 18-gauge needle punctures x 3, treated with hydrogel patches containing F&T, or F&T alone. CT scans after death or at Days 3 and 10. Sacrifice Day 10 for histology.
Right: Staple lines in swine lungs after wedge resection. Ex-vivo lungs will be inflated until air leak occurs through staple lines, then staple lines will be treated with hydrogel patches with F&T, or F&T alone to determine if air leak will stop during one-hour mechanical ventilation.