Effect of donor preservation solution and survival in lung transplantation

Background: The aim of this retrospective study was to determine whether the type of preservation solution significantly alters outcomes in lung transplantation, with particular emphasis on primary graft dysfunction and mortality. Methods: Data on 310 consecutive lung transplant patients, which were prospectively collected, were analyzed. The main outcome variables were all-cause mortality and primary graft dysfunction. Patients were grouped according to donor organ preservation solution, either Euro-Collins, Papworth solution or Perfadex. Multivariate analysis with an additional sensitivity analysis utilizing a propensity score for the use of Papworth solution was performed. Results: Papworth solution was associated with significantly increased mortality compared with the other preservation solutions [odds ratio (OR) = 2.36 (1.21 to 4.58), p = 0.01]. Perfadex was associated with a reduced incidence of primary graft dysfunction at 48 hours (OR = 0.23 [0.08 to 0.68], p = 0.008). Increasing donor age was also associated with increased risk of death (OR = 1.03 [1.01 to 1.04], p = 0.004). Conclusion: Papworth solution for donor lung preservation is associated with an increased mortality in lung transplant recipients.