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Related Experiment Video

Updated: Apr 30, 2026

Study of Experimental Organ Donation Models for Lung Transplantation
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Clinical and System-Level Factors Driving Donor Lung Utilization Decisions: A Qualitative Study.

Brittany Koons1, James D Mendez1, Michaela R Anderson2

  • 1M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania.

Annals of the American Thoracic Society
|March 24, 2025
PubMed
Summary

Lung transplant clinicians consider donor factors, patient complexity, provider experience, and system-level issues when deciding on organ offers. Understanding these influences can improve organ utilization and acceptance rates.

Keywords:
decision-makinglung transplantationtransplant donors

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Area of Science:

  • Thoracic Surgery
  • Transplant Medicine
  • Healthcare Management

Background:

  • Significant variability exists in organ offer acceptance rates across United States transplant centers.
  • Key knowledge gaps hinder understanding of factors driving donor utilization and organ acceptance decisions.

Purpose of the Study:

  • To identify clinical and system-level factors influencing donor evaluation and graft acceptance decisions.
  • To explore the decision-making process of lung transplant clinicians regarding organ offers.

Main Methods:

  • Conducted semi-structured interviews with lung transplant clinicians involved in donor evaluation calls.
  • Included pulmonologists and surgeons actively making donor utilization decisions.
  • Thematic analysis was performed on interview data collected between December 2022 and September 2023.

Main Results:

  • Four themes emerged: variability in acceptable donor factors (age, smoking, oxygenation, imaging), managing donation after cardiac death offers.
  • Complexity in matching critically ill or hard-to-match candidates (highly sensitized, rare blood type) with available organs.
  • Influence of provider training/experience and system factors (allocation, center experience, resources, logistics, data, donor management, OPO collaboration).

Conclusions:

  • Findings provide insight into clinical practice variability in lung transplantation.
  • Identified areas for potential policy changes, clinical training improvements, and future research directions.
  • Understanding these factors can help optimize organ utilization and improve transplant outcomes.