Effectiveness Study of Bundle Maintenance Strategies in Donor Lung Quality Improvement

To assess the efficacy of a bundle donor lung maintenance strategy in enhancing donor lung quality for transplantation. This retrospective study analyzed 155 potential lung donors admitted to Shandong Provincial Hospital (2022-2024). After excluding 76 cases meeting absolute exclusion criteria, 79 donors received a bundle maintenance protocol, including fluid management, targeted anti-infection therapy, airway care, lung-protective ventilation, and VAP prevention. Outcomes were evaluated by comparing pre- and post-maintenance oxygenation index (PaO₂/FiO₂), lactate levels, infection markers (WBC, PCT, IL-6), and transplantable lung rates. Subgroup analysis compared outcomes between prone and nonprone positioning during maintenance. Post-intervention, oxygenation index increased by 77.25% (P < .01), with lactate reduced by 33.33% (P < .01). Infection markers improved significantly: WBC (-16.42%), PCT (-50%), and IL-6 (-61.30%) (P < .01). Transplantable lung rates rose from 49.37% to 87.34% (χ² = 28.03, P < .01), converting 75% of initially nontransplantable lungs. Prone positioning further amplified benefits: ΔOI improvement (median 214 vs 148, P < .01) and 83.33% oxygenation enhancement (P < .01). The bundle strategy effectively optimizes donor lung quality, increasing transplantable grafts by 37.97% and demonstrating the added value of prone positioning. These findings advocate for standardized protocols to address donor shortages while ensuring transplant success.