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Related Experiment Video

Updated: Dec 23, 2025

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Redefining marginality: donor lung criteria.

Jasleen Kukreja1, Joy Chen1, Marek Brzezinski2

  • 1Division of Cardiothoracic Surgery.

Current Opinion in Organ Transplantation
|April 19, 2020
PubMed
Summary
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Lung donor criteria require reevaluation due to organ shortages. Recent data suggest that traditional "marginal" donor lungs, including those with certain comorbidities or longer ischemia times, can be safely used in lung transplantation.

Area of Science:

  • Pulmonology
  • Transplant Surgery
  • Organ Donation

Background:

  • Lung transplantation is increasing globally, but waitlist mortality remains high due to limited organ availability.
  • The demand for lung organs necessitates a critical review of current donor selection criteria.

Purpose of the Study:

  • To redefine lung donor criteria using the latest available data.
  • To address the persistent issue of waitlist mortality in lung transplantation.

Main Methods:

  • Review of recent scientific evidence and clinical data.
  • Analysis of outcomes associated with donors previously considered 'extended criteria'.
  • Evaluation of the impact of new antiviral therapies on organ utilization.

Main Results:

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  • Traditional contraindications for lung donors (e.g., age >55, PaO2/FiO2 <300, ischemia time >6 hours, positive sputum, abnormal radiography) are no longer absolute.
  • Organs from Hepatitis C positive donors show positive outcomes with new antiviral treatments.
  • Organs from donors with a history of smoking can be considered.

Conclusions:

  • The decision to utilize donor lungs should be based on a comprehensive assessment of both donor and recipient factors.
  • The terms 'marginal' or 'extended' criteria for lung donors should be reconsidered and potentially removed.