Lung transplantation following death by drowning: a review of the current literature

Pasupneti, Shravani; Patel, Kapil; Mooney, Joshua J.; Chhatwani, Laveena; Dhillon, Gundeep; Weill, David

doi:10.1111/ctr.12822

Cited by 7 publications

(8 citation statements)

References 9 publications

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“…One such factor is submersion in extremely cold waters (<5°C), which may be associated with lower risk of pneumonia, as many common pathogenic bacteria and fungi often cannot survive in such conditions 8 . Furthermore, the mammalian diving response—an autonomic response triggered by apnea or facial immersion in cold water—leads to vasoconstriction of the tracheal and pulmonary tissues, which may prevent translocation of microorganisms, thus leading to lower infectious burden 6,12 . Such low water temperatures, however, are unlikely to occur in cases of swimming pool drowning, although water chlorination, along with the routine disinfection of swimming pools, may provide some protection from microorganisms 13…”

Section: Discussionmentioning

confidence: 99%

“…One such effort is the use of donor lungs from drowning victims, although this remains a rare occurrence given concerns over lung parenchymal injury and microbial contamination 5 . The limited available literature for LTx from drowning victims has shown favorable outcomes; however, previous studies have focused primarily on drownings in naturally occurring bodies of water, where cold temperatures and lack of chemical contaminants may contribute to successful outcomes 5‐8 . Little is known with regards to outcomes in utilizing donor lungs from swimming pool drownings.…”

Section: Introductionmentioning

confidence: 99%

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Lung transplantation from swimming pool drowning victims: A case series

Tsou

Chen

Brzeziński

et al. 2021

American Journal of Transplantation

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The use of donor lungs from victims of drowning remains a rare occurrence, given concerns over lung parenchymal injury and microbial contamination secondary to aspiration. Given this infrequency, there is a relative paucity of literature surrounding the use of organs from drowned donors, with the few that exist on this subject focusing primarily on cases of drowning in naturally occurring bodies of water (i.e., drowning at sea). Little is known regarding the outcomes of utilizing donor lungs from victims of drowning in artificial bodies of water (i.e., swimming pools). Here, we describe three cases of bilateral lung transplantation from donors who drowned in swimming pools, with good short‐ and long‐term outcomes. These cases lend further evidence to the feasibility of using such organs that have traditionally been viewed with much trepidation. With continually growing demand for donor organs, the use of drowned donor lungs may serve as a means to expand the donor pool and lessen the burden of waitlist mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lung transplantation from swimming pool drowning victims: A case series

Tsou

Chen

Brzeziński

et al. 2021

American Journal of Transplantation

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“…16 However, recent publications have shown that primary graft function and longterm recipient survival may be equal to those of organs from nonasphyxiated donors, even for high-risk organs such as the lung. [17][18][19][20][21] Donor lungs procured from asphyxiated victims often show signs of damage due to barotrauma and edema. 19 The lungs of avalanche victims may be additionally damaged by external thoracic compression and by negativepressure lung injury caused by airway obstruction.…”

Section: Discussionmentioning

confidence: 99%

Solid Organ Donation From Brain-dead Donors With Cardiorespiratory Arrest After Snow Avalanche Burial: A Retrospective Single-center Study

et al. 2021

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Background. Complete snow avalanche burial is associated with high mortality. The aim of this study was to assess the feasibility and incidence of organ retrieval in brain-dead donors following cardiorespiratory arrest due to avalanche burial and to evaluate the function of transplanted organs. Methods. The transplant registry of the Medical University of Innsbruck was searched for organ donors with a history of avalanche burial, and the function and survival of transplanted organs were assessed. Results. Thirty-three organs were procured from eight donors and 31 organs (13 kidneys, 6 livers, 3 pancreases, 5 hearts, and 4 lungs) were ultimately transplanted. Allograft and recipient 1-y survival were 100% and both initial and long-term graft function were good. Only one-third of all avalanche victims who died in the intensive care unit with signs of irreversible hypoxic brain injury became organ donors. Conclusions. Initial experience from this retrospective study suggests that organs from brain-dead avalanche victims can be transplanted with good results. Starting a Donation after Circulatory Determination of Death program might be an option for increasing the number of organ donations from avalanche victims with irreversible hypoxic brain injury.

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“…On the other hand, approximately 10-15% of individuals develop severe and sustained laryngospasm, preventing aspiration of water or gastric contents-"dry drowning" [26]. Cooler temperature, dry drowning, microbiologically sparse environment (i.e., Alaska or Himalayas), deeper bodies of water, and lack of preceding neurological damage are favorable donor criteria following drowning [29]. Objectively, if the imaging does not show any evidence of aspiration or lung edema and pO2/ FiO2 ratio is good enough, a bronchoscopy can help to determine the evidence of aspiration [26,29].…”

Section: Drowningmentioning

confidence: 99%