Feasibility and Utility of a Lung Donor Score: Correlation With Early Post-Transplant Outcomes

Takahiro Oto, Bronwyn J. Levvey, Helen Whitford, Anne P. Griffiths, Tom Kotsimbos, Trevor J. Williams, Gregory I. Snell

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: A lung donor score may provide a numerical value of overall donor lung "quality" to allow comparison among different organizations and research protocols. This study aims to develop a simple scoring system and investigate its applicability on predicting donor selection and early post-lung-transplant (LTx) outcomes. Methods: Data of all donors referred to our institution in 2001 were initially analyzed to create a LTx donor score. Five domains, age, smoking history, chest X-ray, secretions, and arterial blood gas results, were included. A larger cohort of transplant recipients (years 2002 to 2005) was analyzed to validate the score against early post-LTx outcomes. Results: In the initial 2001 cohort, 36 of 87 (41%) donors were used for 41 LTx (used group) and 51 (59%) were declined for medical (lung-exclusion group, n = 31) and general (general-exclusion group, n = 20) reasons. The median donor scores in the used, general-exclusion, and lung-exclusion groups were 2.0, 2.0, and 10.0, respectively (p <0.0001). In multivariate analysis of the validation cohort, the donor score in bilateral LTx was significantly associated with post-transplant ratio of arterial oxygen tension and inspired oxygen fraction (coefficient = -16.19, p = 0.002), primary graft dysfunction grade (coefficient = 0.21, p <0.0001), and intubation hours (coefficient = 0.05, p = 0.04); however, a significant association was not seen in single LTx. Conclusions: A proposed simple donor scoring system, based on five major donor variables available at the time of donor selection, may be useful for data comparison between specific centers, quality control, evaluative research, and clinical decision making in donor selection and management in LTx.

Original languageEnglish
Pages (from-to)257-263
Number of pages7
JournalAnnals of Thoracic Surgery
Volume83
Issue number1
DOIs
Publication statusPublished - Jan 2007
Externally publishedYes

Fingerprint

Tissue Donors
Transplants
Lung
Donor Selection
Primary Graft Dysfunction
Oxygen
Research
Intubation
Quality Control
Arterial Pressure
Thorax
Multivariate Analysis
Gases
Smoking
History
X-Rays

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Oto, T., Levvey, B. J., Whitford, H., Griffiths, A. P., Kotsimbos, T., Williams, T. J., & Snell, G. I. (2007). Feasibility and Utility of a Lung Donor Score: Correlation With Early Post-Transplant Outcomes. Annals of Thoracic Surgery, 83(1), 257-263. https://doi.org/10.1016/j.athoracsur.2006.07.040

Feasibility and Utility of a Lung Donor Score : Correlation With Early Post-Transplant Outcomes. / Oto, Takahiro; Levvey, Bronwyn J.; Whitford, Helen; Griffiths, Anne P.; Kotsimbos, Tom; Williams, Trevor J.; Snell, Gregory I.

In: Annals of Thoracic Surgery, Vol. 83, No. 1, 01.2007, p. 257-263.

Research output: Contribution to journalArticle

Oto, T, Levvey, BJ, Whitford, H, Griffiths, AP, Kotsimbos, T, Williams, TJ & Snell, GI 2007, 'Feasibility and Utility of a Lung Donor Score: Correlation With Early Post-Transplant Outcomes', Annals of Thoracic Surgery, vol. 83, no. 1, pp. 257-263. https://doi.org/10.1016/j.athoracsur.2006.07.040
Oto, Takahiro ; Levvey, Bronwyn J. ; Whitford, Helen ; Griffiths, Anne P. ; Kotsimbos, Tom ; Williams, Trevor J. ; Snell, Gregory I. / Feasibility and Utility of a Lung Donor Score : Correlation With Early Post-Transplant Outcomes. In: Annals of Thoracic Surgery. 2007 ; Vol. 83, No. 1. pp. 257-263.
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AU - Kotsimbos, Tom

AU - Williams, Trevor J.

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AB - Background: A lung donor score may provide a numerical value of overall donor lung "quality" to allow comparison among different organizations and research protocols. This study aims to develop a simple scoring system and investigate its applicability on predicting donor selection and early post-lung-transplant (LTx) outcomes. Methods: Data of all donors referred to our institution in 2001 were initially analyzed to create a LTx donor score. Five domains, age, smoking history, chest X-ray, secretions, and arterial blood gas results, were included. A larger cohort of transplant recipients (years 2002 to 2005) was analyzed to validate the score against early post-LTx outcomes. Results: In the initial 2001 cohort, 36 of 87 (41%) donors were used for 41 LTx (used group) and 51 (59%) were declined for medical (lung-exclusion group, n = 31) and general (general-exclusion group, n = 20) reasons. The median donor scores in the used, general-exclusion, and lung-exclusion groups were 2.0, 2.0, and 10.0, respectively (p <0.0001). In multivariate analysis of the validation cohort, the donor score in bilateral LTx was significantly associated with post-transplant ratio of arterial oxygen tension and inspired oxygen fraction (coefficient = -16.19, p = 0.002), primary graft dysfunction grade (coefficient = 0.21, p <0.0001), and intubation hours (coefficient = 0.05, p = 0.04); however, a significant association was not seen in single LTx. Conclusions: A proposed simple donor scoring system, based on five major donor variables available at the time of donor selection, may be useful for data comparison between specific centers, quality control, evaluative research, and clinical decision making in donor selection and management in LTx.

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