Development of a non-heart-beating donor program and results after the first year

Area of Science:

• Thoracic Surgery
• Transplantation Medicine
• Organ Preservation

Background:

• Lung transplantation is limited by donor organ availability.
• Non-heart-beating donors (NHBDs) offer a potential source for lung grafts.
• Existing preservation methods require adaptation for lung viability from NHBDs.

Purpose of the Study:

• To evaluate the feasibility and outcomes of lung transplantation using grafts from NHBDs.
• To assess the efficacy of a new "bithermia preservation" technique for lung grafts.
• To report the initial clinical experience with NHBD lung transplantation.

Main Methods:

• Development and application of a novel "bithermia preservation" method for multiorgan retrieval.
• Assessment of 15 NHBD lung grafts over a one-year period (June 2010-July 2011).
• Clinical evaluation including chest X-ray, bronchoscopy, pulmonary function tests, and graft implantation.

Main Results:

• Three lung transplants (1 bilateral, 2 unilateral) were performed from NHBDs using bithermia preservation.
• No primary graft dysfunction or in-hospital mortality was observed in the transplanted patients.
• All three patients are alive with excellent graft function and normal lives, with two extubated early.

Conclusions:

• The "bithermia preservation" method is effective for preserving lung grafts from NHBDs.
• NHBD lung transplantation is a viable option to increase donor organ supply.
• This approach facilitates successful multi-organ procurement (liver, kidneys, lungs) from a single donor.