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Updated: Mar 7, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Short- and Long-term Outcomes After Lung Transplantation From Circulatory-Dead Donors: A Single-Center Experience
David Ruttens1, An Martens, Sofie Ordies
11 Division of Respiratory Diseases, Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven/UZ Leuven, Leuven, Belgium. 2 Department of Anesthesiology and Algology, KU Leuven/UZ Leuven, Leuven, Belgium. 3 Department of Thoracic Surgery, KU Leuven/UZ Leuven, Leuven, Belgium.
Insights
Donation after cardiac death (DCD) lung transplants show comparable short- and long-term outcomes to donation after brain death (DBD) transplants. This indicates DCD lung transplantation is a safe and effective strategy to increase organ availability.
Area of Science:
- Cardiology
- Thoracic Surgery
- Transplantation Immunology
Background:
- Donation after cardiac death (DCD) is increasingly utilized to address donor organ shortages.
- Long-term outcomes following DCD lung transplantation (LTx) are not well-established.
- This study compares DCD LTx recipients with donation after brain death (DBD) LTx recipients.
Purpose of the Study:
- To evaluate and compare short-term and long-term outcomes of lung transplantation from DCD donors versus DBD donors.
- To determine the safety and efficacy of DCD lung transplantation as a strategy to increase organ availability.
Main Methods:
- Retrospective comparison of 59 DCD LTx recipients with 331 DBD LTx recipients.
- Data collected from February 2007 to September 2013, with follow-up until January 1, 2016.
- Comparison of short-term outcomes (ventilation duration, ICU/hospital stay, graft dysfunction) and long-term outcomes (chronic lung allograft dysfunction-free survival, overall survival).
Main Results:
- No significant differences were observed in patient demographics (age, disease, LTx type) between DCD and DBD groups, except for a higher proportion of males in the DCD group.
- Short-term outcomes, including mechanical ventilation duration, ICU and hospital stay, and primary graft dysfunction scores, were comparable between DCD and DBD recipients.
- Long-term outcomes, specifically chronic lung allograft dysfunction-free survival and overall survival, did not differ significantly between the two groups.
Conclusions:
- Lung transplantation using DCD donors yields outcomes comparable to those from DBD donors.
- DCD lung transplantation is a safe and viable strategy that enhances transplant activity.
- The findings support the expanded use of DCD donors to mitigate lung allograft shortages.
Background:
Donation after cardiac death (DCD) to overcome the donor organ shortage is well accepted in the clinical setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown.
Methods:
In this retrospective study, DCD LTx recipients (n = 59) were compared with a cohort of donation after brain death (DBD) LTx recipients (n = 331) transplanted between February 2007 and September 2013; follow-up was until January 1, 2016. Short-term (duration of mechanical ventilation, intensive care unit stay, hospital stay, and highest primary graft dysfunction score within 72 hours) and long-term (chronic lung allograft dysfunction-free and overall survival) follow-up were compared over a median follow-up of 50.5 (±3.7) months for DCD and 66.8 (±1.5) months for DBD.
Results:
There were no differences between groups with regard to patient characteristics: age (P = 0.78), underlying disease (P = 0.30) and type of type of LTx (P = 0.10), except sex where more males were transplanted with a DCD donor (62.7%) vs (48.3%, P = 0.048). There was no difference in time on mechanical ventilation (P = 0.59), intensive care unit stay (P = 0.74), highest primary graft dysfunction score (P = 0.67) and hospital stay (P = 0.99). Moreover, chronic lung allograft dysfunction-free (P = 0.86) and overall survival (P = 0.15) did not differ between the DBD and DCD groups.
Conclusions:
In our experience, both short- and long-term outcomes in DCD lung recipients are comparable to that of DBD lung recipients. Therefore, DCD LTx can be considered a safe strategy that significantly increased our transplant activity.
