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Expanding the lung donor pool: advancements and emerging pathways
Jeremie Reeb1, Shaf Keshavjee, Marcelo Cypel
1Division of Thoracic Surgery, Toronto Lung Transplant Program, University of Toronto Toronto Lung Transplant Program, Latner Thoracic Surgery Research Laboratories, Toronto, Ontario, Canada.
Current Opinion in Organ Transplantation
|August 12, 2015
Summary
New strategies like donation after cardiac death (DCD), living-donor lung transplants, and ex-vivo lung perfusion (EVLP) are expanding the donor lung pool for transplantation. These methods improve organ utilization and patient outcomes.
Area of Science:
- Pulmonology
- Transplant Surgery
- Organ Donation
Background:
- Lung transplantation is limited by a shortage of donor organs and low utilization rates.
- Novel strategies are crucial to expand the donor lung pool and meet patient demand.
Purpose of the Study:
- To review recent advancements in increasing the availability of donor lungs for transplantation.
- To evaluate the efficacy and outcomes of emerging donor lung strategies.
Main Methods:
- Review of improved donor management protocols.
- Analysis of lung transplantation from donations after cardiac death (DCD).
- Assessment of lobar living-donor lung (LLLD) transplantation and ex-vivo lung perfusion (EVLP).
Main Results:
- Adapted donor management can increase the donor pool by up to 20%.
- Donation after cardiac death (DCD) lung transplants show comparable outcomes to donation after brain death.
- Lobar living-donor lung (LLLD) transplantation offers excellent results, particularly for pediatric and critically ill patients.
- Ex-vivo lung perfusion (EVLP) enhances lung suitability and provides a platform for reconditioning and therapy.
Conclusions:
- Wider adoption of DCD and LLLD lungs, coupled with EVLP, is expected to significantly increase lung availability for transplantation.
- These strategies hold promise for improving lung transplant accessibility and patient outcomes.
