Lung transplant outcome following donation after euthanasia

Area of Science:

• Transplantation Medicine
• Pulmonology
• Bioethics

Background:

• Organ shortages significantly impede transplantation success.
• Donation after euthanasia, termed donation after cardio-circulatory death category V (DCD-V), is a legal option in some regions.
• This study evaluates lung transplantation outcomes using DCD-V donors.

Purpose of the Study:

• To assess the feasibility and safety of lung transplantation (LTx) utilizing DCD-V allografts.
• To compare post-transplant outcomes of LTx from DCD-V donors with matched cohorts from DCD-III and donation after brain death (DBD) donors.
• To analyze short- and long-term graft and patient survival rates.

Main Methods:

• Retrospective analysis of bilateral lung transplantations performed between 2007 and 2020.
• Matching DCD-V recipients with DCD-III and DBD recipients based on recipient and donor demographics and clinical factors.
• Comparison of primary graft dysfunction (PGD), chronic lung allograft dysfunction (CLAD), and patient survival rates between the groups.

Main Results:

• 2.9% (22 of 769) of lung transplants utilized DCD-V allografts.
• Primary graft dysfunction rates were comparable across DCD-V (23.8%), DCD-III (27.9%), and DBD (32.3%) cohorts.
• 3- and 5-year CLAD-free survival and 5-year patient survival rates were similar across all donor types, indicating comparable long-term outcomes.

Conclusions:

• Lung transplantation using DCD-V allografts is a viable and safe option.
• No significant differences in short-term or long-term outcomes were observed between DCD-V, DCD-III, and DBD lung transplants.
• DCD-V organ donation can help alleviate organ shortages without compromising transplant outcomes.