title: Influence of donor characteristics on outcome after lung transplantation: a multicenter study.
abstract: BACKGROUND
  The liberalization of lung-donor criteria and the use of marginal donors have been advocated to face the current shortage of donors in lung transplantation. However, the impact of donor characteristics on the outcome of lung transplantation is still largely unknown. We aimed to determine, on a large cohort of patients, the effect of donors characteristics on short- and long-term outcome of lung transplantation
  
  
  METHODS
  Between 1988 and 1998, a total of 785 adult patients underwent single-lung transplantation (n = 270), bilateral-lung transplantation (n = 251), and heart-lung transplantation (n = 264) in 7 centers in France. We constructed several multivariate models to assess the relationship between donor characteristics and early gas exchange, duration of mechanical ventilation, and long-term survival after lung transplantation.
  
  
  RESULTS
  Among donor characteristics, donor gas exchange before harvest was found to be significantly associated with recipient early gas exchange, duration of mechanical ventilation, and long-term survival after adjustment for potential confounding variables. Moreover, nonlinear modeling showed a steep increase in the relative risk of death when donor PaO2/FiO2 before harvest was below 350 (hazard ratio 1.43; 95% confidence interval 1.10-1.85; p = 0.01). Donor and recipient sex mismatch were also found to be significantly associated with long-term survival.
  
  
  CONCLUSIONS
  Although liberalization of lung-donor criteria may be considered to overcome the shortage of lung donors, our data suggest that the violation of the gas-exchange criterion should be avoided.
authors.affiliation: Division of Pulmonary Medicine, Beaujon Hospital, Clichy, France. gabriel.thabut@bjn.ap-hop-paris.fr
authors.forename: Gabriel
authors.initials: G
authors.lastname: Thabut
authors.forename: Hervé
authors.initials: H
authors.lastname: Mal
authors.forename: Jacques
authors.initials: J
authors.lastname: Cerrina
authors.forename: Philippe
authors.initials: P
authors.lastname: Dartevelle
authors.forename: Claire
authors.initials: C
authors.lastname: Dromer
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Velly
authors.forename: Marc
authors.initials: M
authors.lastname: Stern
authors.forename: Philippe
authors.initials: P
authors.lastname: Loirat
authors.forename: Michelle
authors.initials: M
authors.lastname: Bertocchi
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Mornex
authors.forename: Alain
authors.initials: A
authors.lastname: Haloun
authors.forename: Philippe
authors.initials: P
authors.lastname: Despins
authors.forename: Christophe
authors.initials: C
authors.lastname: Pison
authors.forename: Daniel
authors.initials: D
authors.lastname: Blin
authors.forename: Gerald
authors.initials: G
authors.lastname: Simonneau
authors.forename: Martine
authors.initials: M
authors.lastname: Reynaud-Gaubert
mesh_terms: D000328:Adult; D002423:Cause of Death; D005260:Female; D005602:France; D006085:Graft Survival; D006801:Humans; D016014:Linear Models; D008168:Lung / Q000502:physiology; D016040:Lung Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014019:Tissue Donors