Cadaveric donor selection and management.
The current availability of lung donors is far exceeded by the number of potential transplant recipients who are waiting for an organ. This disparity results in significant morbidity and mortality for those on the waiting list. Although it is desirable to increase overall consent rates for organ donation, doing so requires an intervention to affect societal response. In contrast, increased procurement of organs from marginal donors and improved donor management may be realized through increased study and practice changes within the transplant community. Transplantation of organs from marginal or extended-criteria donors may result in some increase in complications or mortality, but this possibility must be weighed against the morbidity and risk of death risk faced by individuals on the waiting list. The effects of this trade-off are currently being studied in kidney transplantation, and perhaps in the near future lung transplantation may benefit from a similar analysis. Until that time, the limited data regarding criteria for donor acceptability must be incorporated into practice to maximize the overall benefits of lung transplantation.
Studer
Sean M
SM
Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, 3459 Fifth Avenue, Pittsburg, PA 15213, USA.
Orens
Jonathan B
JB
D000328:Adult; D000367:Age Factors; D002102:Cadaver; D046148:Donor Selection / Q000458:organization & administration*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006648:Histocompatibility / Q000276:immunology*; D006801:Humans; D016040:Lung Transplantation / Q000592:standards* / Q000639:trends; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014181:Transplantation Immunology; D016896:Treatment Outcome; D014850:Waiting Lists