The 2024 American Association for Thoracic Surgery expert consensus document: Current standards in donor lung...

Area of Science:

• Thoracic Surgery
• Transplantation Medicine
• Organ Preservation

Background:

• Donor lung procurement and preservation techniques vary widely, impacting lung transplant success.
• Advancements in cold static preservation and machine perfusion add complexity.
• Standardized best practices are needed to optimize organ utilization and transplant outcomes.

Purpose of the Study:

• To establish evidence-based recommendations for best practices in donor lung procurement and preservation.
• To address the variability in current techniques and incorporate new technological advances.
• To provide guidance for improving lung transplantation numbers and recipient outcomes.

Main Methods:

• An expert panel from the American Association for Thoracic Surgery (AATS) Clinical Practice Standards Committee (CPSC) was convened.
• The panel reviewed existing literature and developed consensus recommendations using a Delphi process.
• Subgroups focused on donor assessment, preservation methods (static, hypothermic, EVLP), and donation after circulatory death (DCD).

Main Results:

• 34 consensus recommendations for donor lung procurement and preservation were established.
• The recommendations cover best practices for both brain-dead and DCD donors.
• Detailed guidance is provided on new cold preservation methods, ex vivo lung perfusion (EVLP), and DCD protocols.

Conclusions:

• Consistent, best-practice protocols in donor lung procurement and preservation are essential.
• Implementing these recommendations can improve lung transplant volumes and patient survival.
• The guidance is intended for all professionals involved in end-stage lung disease care and transplantation.