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Operative Techniques and Pitfalls in Donor Bilateral Lung Procurement
Alex R Dalal1, Daniel E Rinewalt1, John W MacArthur1
1Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
Transplantation Proceedings
|March 7, 2020
Summary
Standardizing the Stanford technique for bilateral lung procurement, whether from donation after brain death or circulatory death, is crucial. This ensures reproducible graft harvesting and preservation, preventing organ loss and improving lung transplant outcomes.
Area of Science:
- Transplantation Surgery
- Organ Procurement
- Thoracic Surgery
Background:
- Growing national demand for lung transplantation.
- Increasing number of lung procurements from both donation after brain death (DBD) and donation after circulatory death (DCD).
Purpose of the Study:
- To describe the Stanford technique for bilateral lung procurement.
- To highlight common pitfalls and mistakes in lung procurement.
- To standardize the procurement process for lung grafts.
Main Methods:
- Detailed description of the Stanford technique for en bloc bilateral lung procurement.
- Focus on DBD and DCD lung procurement procedures.
- Identification of critical steps to prevent organ loss.
Main Results:
- Graft damage during en bloc procurement often stems from poor preservation.
- Injury to pulmonary veins during left atrial cuff division is a common cause of damage.
- The technique aims to minimize these risks.
Conclusions:
- Standardization of en bloc bilateral lung procurement is essential.
- Reproducible graft harvesting and preservation are key goals.
- Effective training for new transplant surgeons is vital for consistent outcomes.
