Donor Lung Procurement by Surgical Fellow With an Expectation of High Rate of Lung Utilisation

Smail, Hassiba; Saxena, Pankaj; Wallinder, Andreas; Lin, Enjarn; Snell, Gregory I; Hobson, Jamie; Zimmet, Adam; Marasco, Silvana; McGiffin, David C.

doi:10.1016/j.hlc.2017.12.007

Cited by 7 publications

(7 citation statements)

References 16 publications

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“…At this moment, there are only moderate evidence‐based criteria for donor lung assessment, based on a combination of donor history, clinical parameters (eg, gas exchange), chest X‐ray, bronchoscopy findings, and ultimately in situ visual inspection by the transplant surgeon . However, donor lung acceptance remains subjective and dependent on the surgeon's expertise …”

Section: Introductionmentioning

confidence: 99%

Histopathologic and radiologic assessment of nontransplanted donor lungs

Vanstapel

Dubbeldam

Weynand

et al. 2020

American Journal of Transplantation

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Donor organ shortage results in significant waiting list mortality. Donor lung assessment is currently based on donors’ history, gas exchange, chest X‐ray, bronchoscopy findings, and ultimately in situ inspection but remains subjective. We correlated histopathology and radiology in nontransplanted donor lungs with the clinical indications to decline the offered organ. Sixty‐two donor lungs, not used for transplantation (2010‐2019), were procured, air‐inflated, frozen, scanned with computed tomography, systematically sampled, and histologically and radiologically assessed. Thirty‐nine (63%) lungs were declined for allograft‐related reasons. In 13/39 (33%) lungs, histology could not confirm the reason for decline, in an additional 8/39 (21%) lungs, histologic abnormalities were only considered mild. In 16/39 (41%) lungs, radiology could not confirm the reason for decline. Twenty‐three (37%) donor lungs were not transplanted due to extrapulmonary causes, of which three (13%) lungs displayed severe histologic abnormalities (pneumonia, n = 2; emphysema, n = 1), in addition to mild emphysema in 9 (39%) lungs and minor bronchopneumonia in 1 (4%). Radiology revealed ground‐glass opacities in 8/23 (35%) and emphysema in 4/23 (17%) lungs. Histopathologic and radiologic assessment of nontransplanted donor lungs revealed substantial discrepancy with the clinical reason for decline. Optimization of donor lung assessment is necessary to improve current organ acceptance rates.

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Section: Introductionmentioning

confidence: 99%

Histopathologic and radiologic assessment of nontransplanted donor lungs

Vanstapel

Dubbeldam

Weynand

et al. 2020

American Journal of Transplantation

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“…Using different EDC definitions and various ex vivo perfusion systems, groups have reported acceptable [7,8,12,13,[58][59][60] outcomes.…”

Section: Results Of Edc Lungsmentioning

confidence: 99%

“…Unfortunately, the number of discarded lungs has also increased [55] and the donor utilization rate remains near 19% [57]. In the last two decades, the transplant programs underwent continuous evolution in donor organ acceptance practices using EDC, significantly improving donor utilization rates, in some centers up to 70% [12,13]. From the UNOS registry data, 56% of donor lungs used varied from the SDC criteria by at least one count, 41% had chest X-ray abnormalities, 18% had PaO 2 less 300 mmHg, and 21% had a history of smoking more than 20 packs years [5].…”

Section: Practical Considerations For Donor Quality Assessmentmentioning

confidence: 99%

Donor quality assessment and size match in lung transplantation

Mangukia

Shigemura

Brann

et al. 2021

Indian J Thorac Cardiovasc Surg

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“…28 The current system of deceased organ procurement for lungs requires a robust system of fellows who may not be as experienced and well versed with variation in OPO protocols. 29 Potentially, the relationship between total ischemic time and distance may be impacted by the organization of deceased donor procurements. Hence, how deceased donor procurements are organized may affect logistical efficiency, which in turn affects the logistical complexity associated with continuous distribution.…”

Section: Discussionmentioning

confidence: 99%