HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Clemens Aigner Gernot Seebacher Gyorgy Lang Wilfried Wisser Walter Klepetko Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Aigner, C. Articles by Klepetko, W. Search for Related Content PubMed PubMed Citation Articles by Aigner, C. Articles by Klepetko, W. Related Collections Lung - transplantation

Eur J Cardiothorac Surg 2005;27:757-761
© 2005 Elsevier Science NL

Extended donor criteria for lung transplantation—a clinical reality

^a Department of Cardiothoracic Surgery, Vienna Medical University, Waehringer Guertel 18-20, 1090 Vienna, Austria
^b Thoracic Surgery Clinic, Koranyi National Institute for Pulmonology, Budapest, Hungary

Received 7 September 2004; received in revised form 31 December 2004; accepted 12 January 2005.

^* Corresponding author. Tel.: +43 1 40400 5644; fax: +43 1 40400 5642. (E-mail: walter.klepetko{at}meduniwien.ac.at).

Objective: Standard lung donor criteria have been established on opinions and individual experiences rather than on existing evidence. Since the scarcity of donor organs is one of the major limitations to lung transplantation, extension of donor lung criteria might considerably increase the donor pool. This study therefore evaluates the outcome, achieved with the use of extended donors versus standard donors and aims to redefine lung donor criteria. Methods: We performed a retrospective analysis of 98 consecutive primary lung transplantations from 94 donors from 1/2001 to 12/2002. Donors were classified as extended if they fulfilled at least one criteria: age >55 years, PaO₂ at FiO₂/PEEP 5 <300mmHg, tobacco history >20 pack years, inhalative drug abuse, presence of infiltration on chest X-ray or purulent secretions at bronchoscopy. Recipients were stratified in two groups according to whether they received a ‘standard’ or ‘extended’ organ. Postoperative complications, extubation time, ICU and hospital stay and survival were compared. Results: Twenty-three (24.5%) donors were extended. Twenty-six recipients (26.55%) received organs from extended donors. Differences in intubation times (12±2 days standard vs. 14±5 days extended, P=0.70), ICU stay (16±2 days standard vs. 18±5 days extended, P=0.74) and hospital stay (38±4 days standard vs. 40±6 days extended, P=0.71) were not statistically significant. Postoperative bleeding rates were comparable (n=14 standard vs. n=3 extended) as well as bronchial anastomotic complications (n=7 standard vs. n=3 extended). Three months survival was 88.89% in the standard group vs. 92.31% in the extended group. One year survival is comparable as well with 81.94 vs. 84.62%, respectively. Conclusions: The use of lung donors who fail to meet standard criteria does not impair short and medium term results compared to standard lung donors. The impact on long term development of BOS has yet to be evaluated. The strict application of standard lung donor criteria excludes a considerable number of lungs potentially suitable for transplantation, thus liberalisation of donor criteria might help to overcome donor shortage.

Key Words: Lung transplantation • Donors • Presumed consent

This article has been cited by other articles:

				M. Shihata, N. Ghorpade, D. Lien, and D. Modry Ex vivo bilateral pulmonary embolectomy for donor lungs prior to transplantation. Ann. Thorac. Surg., June 1, 2008; 85(6): 2110 - 2112. [Abstract] [Full Text] [PDF]

				R. V. Venkateswaran, V. B. Patchell, I. C. Wilson, J. G. Mascaro, R. D. Thompson, D. W. Quinn, R. A. Stockley, J. H. Coote, and R. S. Bonser Early Donor Management Increases the Retrieval Rate of Lungs for Transplantation Ann. Thorac. Surg., January 1, 2008; 85(1): 278 - 286. [Abstract] [Full Text] [PDF]

				T. Oto, B. J. Levvey, H. Whitford, A. P. Griffiths, T. Kotsimbos, T. J. Williams, and G. I. Snell Feasibility and Utility of a Lung Donor Score: Correlation With Early Post-Transplant Outcomes Ann. Thorac. Surg., January 1, 2007; 83(1): 257 - 263. [Abstract] [Full Text] [PDF]

				L. F. Angel, D. J. Levine, M. I. Restrepo, S. Johnson, E. Sako, A. Carpenter, J. Calhoon, J. E. Cornell, S. G. Adams, G. B. Chisholm, et al. Impact of a Lung Transplantation Donor-Management Protocol on Lung Donation and Recipient Outcomes Am. J. Respir. Crit. Care Med., September 15, 2006; 174(6): 710 - 716. [Abstract] [Full Text] [PDF]