Suboptimal Donors Do Not Mean Worse Results: A Single-Center Study of Extending Donor Criteria for Lung Transplant

• Published in: Transplantation proceedings 2020-09, Vol.52 (7), p.2123-2127
• Main Authors: Urlik, Maciej, Latos, Magdalena, Antończyk, Remigiusz, Nęcki, Mirosław, Kaczur, Emilia, Miernik, Marcelina, Zawadzki, Fryderyk, Król, Bogumiła, Pasek, Piotr, Przybyłowski, Piotr, Zembala, Marian, Ochman, Marek, Stącel, Tomasz
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Lung Transplantation - methods; Male; Middle Aged; Retrospective Studies; Tissue Donors - supply & distribution; Transplants - supply & distribution; Treatment Outcome
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2020.03.042

Lung transplant remains the only viable treatment for most of the end-stage lung diseases. It is believed that extending criteria for donor lungs would increase the number of lung transplants. The aim of the study was to compare the graft function by means of oxygenation index among recipients who received the lungs from donors of extended criteria with those whose received lungs from donors who met the standard criteria. This retrospective study analyzed 71 donors whose lungs where transplanted into 71 first-time double lung recipients of 2 groups: patients who received transplants before and after 2018. The objective was to assess whether there is a significant difference in quality of the donor pool after applying extended criteria. The second objective was to compare results of recipients with lungs from donors of oxygenation index > 400 mm Hg with those obtained among recipients with this parameter < 400 mm Hg. In the case of transplants performed in 2018 to 2019, oxygenation indices were significantly lower in donors but significantly higher in recipients on the first day than those observed in 2015 to 2017. The number of transplants increased from 9 per year to 22 per year. Irrespective of whether the donor had PaO2/fraction of inspired oxygen above or below 400 mm Hg, recipients showed similar oxygenation index values after transplant (mean oxygenation index, 462 vs 412 mm Hg, respectively). Short-term mortality did not differ either. Extended criteria of lungs suitability as a potential grafts not only increases the donor pool but also proves that suboptimal donors are not associated with producing inferior results of the recipients. •Suboptimal donors are not associated with inferior short-term survival of double lung transplant recipients.•Donor pool increased after extending the lower limit of admissible oxygenation index.•Postoperative oxygenation index of first-time graft recipients receiving lungs of PaO2/Fio2 < 400 mm Hg at donor reporting does not differ from those with PaO2/Fio2 > 400 mm Hg among double lung transplant recipients.