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Related Experiment Videos

Marginal donor lungs: a reassessment.

Andrew F Pierre1, Yasuo Sekine, Michael A Hutcheon

  • 1Toronto Lung Transplant Program, Toronto General Hospital, University of Toronto, 200 Elizabeth Street, EN 10-224, Toronto, Ontario M5G 2C4, Canada.

The Journal of Thoracic and Cardiovascular Surgery
|March 8, 2002
PubMed
Summary

Using extended donor lungs in lung transplantation may increase early mortality. Careful selection of extended donor lungs is crucial, especially for recipients outside standard guidelines, to ensure better patient outcomes.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Transplant Surgery

Background:

  • Lung transplantation faces donor shortages, leading to the use of extended criteria donors.
  • Previous reports suggested comparable outcomes with extended donor lungs, encouraging wider application.

Purpose of the Study:

  • To reevaluate outcomes of lung transplantation using extended donor lungs compared to standard donor lungs.
  • To assess outcomes in recipients outside established guidelines when using extended donor lungs.

Main Methods:

  • Retrospective review of 128 lung or heart-lung transplants (1997-2000).
  • Defined extended donors by criteria including age >55, >20 pack-year smoking history, radiographic infiltrate, PO2 <300 mmHg, or purulent bronchoscopy.
  • Categorized recipients as guideline or nonguideline based on published criteria.

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Main Results:

  • 51% of donors (63/123) met extended criteria.
  • 30-day mortality was 6.2% for standard donors vs. 17.5% for extended donors (P=.047).
  • Nonguideline recipients showed acceptable early mortality, except when receiving extended donor lungs.

Conclusions:

  • While some extended donor lungs function acceptably, increased early mortality is observed in this recipient group.
  • Caution is advised when using certain extended donor lungs due to higher early mortality risks.
  • Nonguideline recipients are particularly vulnerable when transplanted with extended donor lungs.