Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2018 Dec 20;24(6):296-302.
doi: 10.5761/atcs.oa.18-00098. Epub 2018 Jul 2.

Lung Transplantation with Controlled Donation after Circulatory Death Donors

Ilhan Inci  1 , Sven Hillinger  1 , Didier Schneiter  1 , Isabelle Opitz  1 , Macé Schuurmans  2 , Christian Benden  2 , Walter Weder  1
Affiliations
Comparative Study

Lung Transplantation with Controlled Donation after Circulatory Death Donors

Ilhan Inci et al. Ann Thorac Cardiovasc Surg. .

Abstract

Purpose: Utilization of donation after circulatory death (DCD) donors has the potential to decrease donor shortage in lung transplantation (LTx). This study reviews the long-term outcome of LTx from DCD donors.

Methods: We included all consecutive DCD (Maastricht Category III) and all donations after brain death (DBD) donor lung transplants at our Center performed between January 2012 and February 2017. Data were analyzed comparing the two groups in regard of survival after LTx as primary outcome.

Results: Median withdrawal to cardiac arrest time was 17 min (interquartile range [IQR]: 11.5-20.5). Median cardiac arrest to cold perfusion was 32 min (IQR: 24.5-36.5). Primary graft dysfunction (PGD) grade 3 at T72 occurred in three recipients. Chronic lung allograft dysfunction (CLAD) led to death in two cases. In DCD group, there was no 90-day mortality. In DCD, group 1- and 3-year survival rates were 100% and 80%. In DBD group, 1- and 3-year survival rates were 85% and 69% (p = 0.4).

Conclusions: Our report confirmed the comparable outcome from DCD donors compared with DBD donors. Utility of DCD donors is a safe option to overcome donor shortage.

Keywords: controlled DCD; donation after cardiac death; lung transplantation; survival.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1. PGD. Proportions of the different PGD grades at 0, 24, 48, and 72 h after transplantation in DCD and DBD recipients. The number of patients is given on the bars. No significant difference was found. PGD: primary graft dysfunction; DCD: donation after circulatory death; DBD: donation after brain death
Fig. 2
Fig. 2. The correlation of different three time intervals for WIT (cardiac arrest–cold perfusion (A), WLST–cold perfusion (B), and sBP <50 mmHg–cold perfusion (C)) with PGD grade 3 at T72. No significant correlation for three time intervals and occurrence of PGD grade 3 at T72 was detected. sBP: systolic blood pressure; WLST: withdrawal of lifesustaining therapy; WIT: warm ischemic time; PGD: primary graft dysfunction
Fig. 3
Fig. 3. CLAD-free survival in DCD and DBD groups. CLAD-free survival was comparable between the groups. CLAD: chronic lung allograft dysfunction; DCD: donation after circulatory death; DBD: donation after brain death
Fig. 4
Fig. 4. Post-transplant survival in DCD and DBD groups. Actuarial survival rates were comparable between the two groups. DCD: donation after circulatory death; DBD: donation after brain death
See this image and copyright information in PMC

References

    1. Van Raemdonck DE, Rega FR, Neyrinck AP, et al. Non-heart-beating donors. Semin Thorac Cardiovasc Surg 2004; 16: 309-21. - PubMed
    1. Avlonitis VS, Fisher AJ, Kirby JA, et al. Pulmonary transplantation: the role of brain death in donor lung injury. Transplantation 2003; 75: 1928-33. - PubMed
    1. Valapour M, Skeans MA, Heubner BM, et al. OPTN/SRTR 2012 annual data report: lung. Am J Transplant 2014; 14: 139-65. - PubMed
    1. Toronto Lung Transplant Group Unilateral lung transplantation for pulmonary fibrosis. N Engl J Med 1986; 314: 1140-5. - PubMed
    1. Hardy JD, Webb WR, Dalton ML, et al. Lung homotransplantation in man. JAMA 1963; 186: 1065-74. - PubMed

Publication types