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Lung transplantation through controlled donation after circulatory death (cDCD) has slowly gained universal acceptance with reports of equivalent outcomes to those through donation after brain death. In contrast, uncontrolled DCD (uDCD) lung use is controversial and requires ethical, legal and medical complexities to be addressed in a limited time. Consequently, uDCD lung use has not previously been reported in the United States. Despite these potential barriers, we present a case of a patient with multiple gunshot wounds to the head and the body who was unsuccessfully resuscitated and ultimately became an uDCD donor. A cytomegalovirus positive recipient who had previously consented for CDC high-risk, DCD and participation in the NOVEL trial was transplanted from this uDCD donor, following 3 hours of ex vivo lung perfusion. The postoperative course was uneventful and the recipient was discharged home on day 9. While this case represents a “best-case scenario,” it illustrates a method for potential expansion of the lung allograft pool through uDCD after unsuccessful resuscitation in hospitalized patients.

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transfusion were most commonly younger trauma patients. Following adjustment for confounding variables, massive transfusion was significantly associated with an increased risk in 30-day (OR = 1.41; CI 1.03, 1.92; p-value = .03) and 90-day mortality (OR = 1.36; CI 1.06, 1.73; p-value = .01) but not 1 year mortality (OR = 1.17; CI 0.97, 1.41; p-value = .11). There was no significant difference in length of stay or hospital free days with respect to donor transfusion. Conclusion: Massive donor blood transfusion (> 10 units) increases early mortality after lung transplantation. Conversely, sub-massive donor transfusion does not increase donor risk. The mechanism of increased early mortality in massively transfused donors is unclear but is consistent with increased mortality risk seen with primary graft dysfunction.