A practical approach to clinical lung transplantation from a Maastricht Category III donor with cardiac death

Although donation after cardiac death (DCD) has the potential to provide a novel source of organs for lung transplantation, even in a controlled DCD situation such as a Maastricht Category III donor (withdrawal of treatment), the limited time frame available after the declaration of death to initiate procurement and preservation remains challenging. Indeed, no publication has detailed the exact time frames and technique applicable for successful Maastricht Category III DCD lung procurement. In this patient report, withdrawal of life-support treatment and death certification was performed in the intensive care unit and the lungs were procured in an operating room 49 minutes after cardiac arrest and successfully transplanted (cold ischemia time <6 hours) into a severely ill recipient with primary pulmonary hypertension.