Outcomes of lung and heart-lung transplants utilizing donor after circulatory death with thoracoabdominal normothermic regional perfusion

• Published in: JHLT Open 2024-05, Vol.4, p.100058, Article 100058
• Main Authors: Chang, Stephanie H., Geraci, Travis C., Piper, Greta L., Chan, Justin, James, Les, Paone, Darien, Sommer, Philip M., Natalini, Jake, Rudym, Darya, Lesko, Melissa, Hussain, Syed T., Reyentovich, Alex, Moazami, Nader, Smith, Deane E., Angel, Luis
• Format: Article
• Language: English
• Subjects: donation after circulatory death; heart-lung transplant; lung transplant; primary graft dysfunction; thoracoabdominal normothermic regional perfusion
• ISSN: 2950-1334; 2950-1334
• DOI: 10.1016/j.jhlto.2024.100058

Background: Donation after circulatory death with thoracoabdominal normothermic regional perfusion (DCD-NRP) for cardiac transplant has promising results, though data for lung transplant is lacking. This study evaluates lung transplant outcomes using DCD-NRP allografts. Methods: All patients who underwent lung transplantation (LT) from June 1, 2020, to July 5, 2023, at a single institution were evaluated. Recipients received organs from DCD-NRP or brain dead (control) donors (donation after brain death (DBD)). All DCD-NRP were adult, primary bilateral LT (BLT) without preoperative extracorporeal membrane oxygenation (ECMO). Inclusion criteria for controls were age >18 years, BLT, no preoperative ECMO, and primary transplantation. Comparison was separated by LT or heart-lung transplant (HLT). The primary outcome was primary graft dysfunction (PGD) grade 3 at 72 hours. Results: There were 8 LT and 3 HLT in the DCD-NRP cohort, and 138 BLT and 7 HL DBD controls. PGD grade 3 at 72 hours was 0% in the entire DCD-NRP cohort (vs control: 9.4% LT and 0% HLT). There were no statistically significant differences in donor and recipient characteristics, though DCD-NRP HLT had significantly shorter ischemic time (85 vs 200 minutes, p