Related Experiment Video
Updated: Aug 15, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Systemic Mitochondrial DNA Kinetics After cDCD Lung Transplantation Do Not Reflect Donor Warm Ischemic Injury:
Irene Bello1, Ramon Martí2, Aroa Gómez-Brey3
1Thoracic Surgery and Lung Transplant Department. Vall d'Hebron University Hospital, Barcelona, Spain; Organs, tissues and cells donation and transplantation research group. Vall d'hebron Research Institute (VHIR) Barcelona, Spain.
Controlled donation after circulatory determination of death (cDCD) lung donors show increased cell-free mitochondrial DNA (cf-mtDNA) post-transplant. This increase reflects recipient inflammation, not donor warm ischemic injury.
Area of Science:
- Transplantation immunology
- Mitochondrial biology
- Organ preservation
Background:
- Controlled donation after circulatory determination of death (cDCD) expands the lung donor pool.
- Biological consequences of donor warm ischemia on mitochondrial injury and systemic danger signaling are uncertain.
- Systemic cell-free mitochondrial DNA (cf-mtDNA) behavior in ventilated human lungs requires further characterization.
Purpose of the Study:
- To characterize donor and recipient plasma cf-mtDNA kinetics in lung transplant recipients.
- To evaluate the relationship between cf-mtDNA and warm ischemic exposure in cDCD versus donors after brain death (DBD).
Main Methods:
- Prospective, multicenter observational study.
- Matched adult lung transplant recipients from cDCD and DBD donors.
- Serial plasma sampling from donors and recipients.
- Longitudinal analysis of cf-mtDNA levels and warm ischemia time.
Main Results:
- Donor plasma cf-mtDNA levels were comparable between cDCD and DBD groups.
- A significant donor type-by-time interaction emerged 72 hours post-transplantation.
- Neither total nor functional warm ischemia time correlated with cf-mtDNA concentrations.
- Graft-derived cf-mtDNA declined post-reperfusion, while total cf-mtDNA increased.
Conclusions:
- Post-transplant systemic cf-mtDNA dynamics are influenced by recipient-driven inflammatory processes.
- cf-mtDNA is not a direct surrogate of donor warm ischemic injury in lung transplantation.
- Understanding cf-mtDNA kinetics is crucial for optimizing lung transplant outcomes.
