Early lung transplantation success utilizing controlled donation after cardiac death donors

G. I. Snell, B. J. Levvey, T. Oto, R. McEgan, D. Pilcher, A. Davies, S. Marasco, F. Rosenfeldt

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Donation-after cardiac death (DCD) donor organs have potential to significantly alleviate the shortage of transplantable lungs. However, only limited data so far describes DCD lung transplantation (LTx) techniques and results. This study aims to describe the Alfred Hospital's early and intermediate outcomes following DCD donor LTx. Following careful experimentation and consultation DCD guidelines were created to utilize Maastricht category III lung donors from either the ICU or operating room(OR), with a warm ischemic time(WIT) of <60 min. Between May 2006 and December 2007, 22 referred DCD donors led to 11 attempted retrievals after withdrawal, resulting in 8 actual bilateral LTx (2 donors did not arrest in prescribed period and 1 donor had nonacceptable lungs). ICU WIT = 38.4 min (range 20-54, OR WIT = 12.7 min (11-15), p < 0.05. Post-LTx, 1 pulmonary hypertensive patient required ECMO for PGD3. The mean group pO2/FiO2 ratio at 24 hours was 307.7 (240-507) with an ICU stay of 9.5 days (2-21) and ward stay of 21.5 days (11-76). All 8 survive at a mean of 311 days (10-573) with good performance status and lung function. In conclusion, the use of Maastricht category III lungs for human LTx is associated with acceptable early clinical outcomes.

Original languageEnglish
Pages (from-to)1282-1289
Number of pages8
JournalAmerican Journal of Transplantation
Volume8
Issue number6
DOIs
Publication statusPublished - Jun 1 2008

Keywords

  • Donation referral
  • Donor management
  • Early graft function
  • Lung transplantation
  • Nonbeating heart donor

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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  • Cite this

    Snell, G. I., Levvey, B. J., Oto, T., McEgan, R., Pilcher, D., Davies, A., Marasco, S., & Rosenfeldt, F. (2008). Early lung transplantation success utilizing controlled donation after cardiac death donors. American Journal of Transplantation, 8(6), 1282-1289. https://doi.org/10.1111/j.1600-6143.2008.02231.x