Utilizing lung donors with recent massive pulmonary emboli and chronic thromboembolic disease for transplantation

Organ availability remains a persistent problem in lung transplantation. The use of organs from donors with chronic thromboembolic disease has not been described. In this report, we discuss 2 lung transplant recipients who received organs from donors with acute bilateral pulmonary embolism. All organs underwent backtable pulmonary thromboendarterectomy before implantation and notably showed evidence of chronic thromboembolic disease and subacute changes in the distal vasculature. Grafts were placed with both patients on venoarterial extracorporeal membrane oxygenation. Both patients had unremarkable hospital courses with graft dysfunction scores of 0 at 48 and 72 hours. At follow-up, both patients remained free of graft rejection. We highlight the utility of lungs derived from chronic thromboembolic disease as a strategy to expand the organ pool.