Maximizing Lung Transplant Donor Utilization: Developing a Lobar Donor Repository Guided by Chest Computed Tomography...

Area of Science:

• Medical Imaging
• Thoracic Surgery
• Organ Transplantation

Background:

• Assessing donor lung viability is critical for successful lung transplantation.
• Brain-dead donors present unique challenges in lung evaluation.
• Standardized protocols for chest CT interpretation in organ donation are needed.

Purpose of the Study:

• To develop and validate a visual scoring system for chest Computed Tomography (CT) findings in brain-dead organ donors.
• To assess the correlation between CT scores and donor lung utilization for transplantation.
• To explore the utility of chest CT visual scoring as a screening tool for donor lung assessment.

Main Methods:

• Retrospective cohort study of 151 brain-dead donors.
• Development of a chest CT evaluation protocol based on Fleischner Society guidelines.
• Lobe-by-lobe scoring of lung lesions on CT for statistical analysis.

Main Results:

• 56 (37.09%) donors underwent lung transplantation.
• Transplanted lungs showed better characteristics and lower CT scores.
• A higher Total Lung Score (TLS) was significantly associated with lower lung utilization (OR 0.643, p < 0.001).
• Receiver Operating Characteristic (ROC) curve analysis showed good discriminative ability for TLS (AUC = 0.803).
• Overall utilization rate of potential lung lobes reached 79.22% based on CT scoring.

Conclusions:

• High Total Lung Score (TLS) negatively impacts donor lung utilization.
• Chest CT visual scoring is a valuable univariable tool for assessing donor lungs from brain-dead donors.
• TLS demonstrates good diagnostic accuracy and potential as a practical screening tool for lung donor assessment.