title: Average P/F ratio during donor management for finding out the potential donor of lung procurement.
abstract: We investigated the potential donors from cases without lung procurement in spite of considering procurement as the donor. We reviewed 207 cases considered for lung procurement. Donors were divided into 2 groups according to whether or not their lungs were harvested: 50 did and 157 did not. We investigated their age, gender, donor management periods, blood pressure, heart rate, P/F ratio, PCO2, HCO3, positive end-expiratory pressure (PEEP), respiratory rate, abnormal findings in the chest X-ray, blood chemistries, sputum culture, and intravenous administration of steroid. Univariable or multivariable logistic regression analysis was used to predict lung harvesting by various factors. Univariable logistic regression analysis revealed maximum heart rate (HR) and respiratory rate (RR), maximum, minimum, and average P/F ratio, and abnormal findings in the chest X-ray, to be predictors to perform transplant. The maximum HR and RR of the non-harvest group are higher than those of the harvest group. Multivariable logistic regression analysis revealed average P/F ratio only to be a predictor to transplant. We divided the non-harvest group into 2 groups according to whether or not their P/F ratio was >300: 55 did (P/F 300 group) and 102 did not (P/F 299 group). Between P/F 299 group and the harvest group, univariable logistic regression analysis revealed maximum HR, maximum and minimum RR, maximum PEEP, maximum, minimum, and average P/F ratio, and abnormal findings in the chest X-ray to be predictors to transplant. Maximum HR, PEEP, and maximum and minimum RR of the P/F 299 group are higher than those of the harvest group. Maximum, minimum, and average P/F ratio of the P/F 299 group are lower than those of the harvest group. The average PCO2 of P/F 299 group is higher than that of the harvest group. The rate of abnormal findings in the chest X-ray of the P/F 299 group is higher than that of the harvest group. Multivariable logistic regression analysis revealed average P/F ratio only to be a predictor to transplant. There were no predictors between the P/F 300 group and the harvest group in both univariable and multivariable logistic regression analyses. Furthermore, there were no different factors between the P/F 300 group and the harvest group. Our study showed that 35.5% of the non-harvest group had a P/F ratio of >300 and had no difference compared with the harvest group. Our data suggest that potential donors existed in the non-harvest group and increased the number of lung procurement to 27.3% from 13.0% of all donors.
authors.affiliation: Advanced Surgery, Graduate School of Medicine, Gifu University, Gifu City, Gifu, Japan. ihisashi@cc.gifu-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Iwata
authors.forename: H
authors.initials: H
authors.lastname: Takemura
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Shirahashi
authors.forename: S
authors.initials: S
authors.lastname: Matsumoto
authors.forename: S
authors.initials: S
authors.lastname: Yoshikawa
authors.forename: Y
authors.initials: Y
authors.lastname: Umeda
authors.forename: Y
authors.initials: Y
authors.lastname: Iwaki
mesh_terms: D001794:Blood Pressure; D005260:Female; D006801:Humans; D008168:Lung; D008297:Male; D018579:Patient Selection; D011013:Pneumonectomy; D011175:Positive-Pressure Respiration; D012044:Regression Analysis; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting