BRIEF COMMUNICATION
Excellent long-term outcome with lungs obtained from uncontrolled donation after circulatory death

https://doi.org/10.1111/ajt.15237Get rights and content
Under a Creative Commons license
open archive

We aimed to propose a simple and effective preservation method in lungs procured for transplantation from uncontrolled donation after circulatory death (uDCD) associated with excellent long-term results. Outcome measures for lung recipients were survival and primary graft dysfunction (PGD) grade 3. Survival was estimated using the Kaplan–Meier method. A total of 9 lung uDCDs were evaluated and 8 lung transplants were performed. Mean no-flow time was 9.8 minutes (standard deviation [SD] 8.6). Mean time from cardiac arrest to topical cooling was 96.8 minutes (SD 16.8). Preservation time was 159 minutes (SD 31). Ex vivo lung perfusion was used to assess lung function prior to transplantation in 2 cases. Mean recipient age was 60.8 years (SD 3.1), and mean total ischemic time was 678 minutes (SD 132). PGD grade 3 was observed in 2 cases (25%). The 1-month, 1-year, and 5-year survival rates were 100%, 87.5%, and 87.5%, respectively. Mean follow-up was 52 months. The logistic complexity of procuring lungs from uDCDs for transplantation requires the development of new strategies designed to facilitate this type of donation. A program based on strict selection criteria, using a simple and effective preservation technique, may recover lung grafts with excellent long-term posttransplant outcomes.

KEYWORDS

clinical research/practice
donation after circulatory death (DCD)
donors and donation
lung transplantation/pulmonology
organ perfusion and preservation
organ procurement
organ procurement and allocation
transplant coordinator

Abbreviations

aCPR
advanced cardiopulmonary resuscitation
cDCD
controlled donation after circulatory death
DBD
donation after brain death
DCD
donation after circulatory death
ECMO
extracorporeal membrane oxygenation
EVLP
ex vivo lung preservation
ICU
intensive care unit
IQR
interquartile range
SD
standard deviation
uDCD
uncontrolled donation after circulatory death
WIT
warm ischemic time

Cited by (0)