Impact of a Lung Transplantation Donor–Management Protocol on Lung Donation and Recipient Outcomes

Abstract

The protocol was associated with a significant increase in the number of lung donors and transplant procedures without compromising pulmonary function, length of stay, or survival of the recipients.

Brain death and its implications for management of the potential organ donor

“…Frequent endotracheal suctioning to keep the airways clean and physiotherapy, together with gentle lung recruitment to avoid atelectasis, is associated with increased rates of lung procurement and improved quality of organs. 21,131 As discussed previously, hypervolemia may rapidly deteriorate gas exchange, and the use of diuretics is often necessary. Another way to decrease excess alveolar fluid is inhalation of a b 2 -adrenergic agonist, which may increase the rate of alveolar fluid clearance.…”

Manejo del potencial donante cadáver

“…dosis bajas de vasopresores 20,22 . Esto es importante pues el aporte excesivo de fluidos puede afectar la viabilidad de órganos, particularmente de los pulmones 23,24 . Con respecto al tipo de fluidos no hay evidencias claras sobre cuál es el más apropiado, pero los cristaloides parecen ser preferibles al uso de coloides en esta condición 1 .…”

Update on lung transplantation: programmes, patients and prospects

“…Complementary to this approach is the use of simple strategies which may convert potential donors to donors falling within standard criteria. Approaches such as bronchoscopic toilet, antibiotic strategies, physiotherapy and ventilation strategies are all reported [42,43].…”