Results of clinical lung transplant from uncontrolled non-heart-beating donors.
BACKGROUND
The scarcity of grafts for lung transplant and the growing number of candidates expecting an organ has led to an increase of deaths in patients waiting for lung transplantation. Non-heart-beating donors (NHBD) represent a promising source of grafts for those who are involved in clinical lung transplantation. We present the results of our series of 17 out-of-hospital NHBD lung transplantations performed since 2002.


METHODS
We have collected data from 17 donors and recipients involved in NHBD lung transplants since 2002, as well as data referring to the type of procedure and peri-operative events. We describe the incidence of post-operative complications with special attention to primary graft disfunction (PGD), bronchial healing, bronchiolitis obliterans syndrome (BOS), and survival. We used Kaplan-Meier method to obtain the survival curve.


RESULTS
G2-G3 PGD was reported in 9 patients (53%), with a complete restoration of the partial pressure of arterial oxygen/fraction of inspired oxygen ratio in 170 hours for G2 and 168 hours for G3. There were no deaths directly related to PGD. Acute rejection was detected in 7 patients (41%), 4 of which exceeded grade 1. The incidence of BOS after transplantation was 1 (7%) of 14 patients during the first year, 2 (11%) of 9 in the second year, and 2 (50%) of 4 in the third year. Hospital mortality rate was 17%. The survival rates were 82% at 3 months, 69%, at 1 year, and 58% at 3 years.


CONCLUSIONS
Mid-term results confirm the adequacy of uncontrolled NHBD as a promising complementary source of lung donors for clinical transplant.
de Antonio
David Gómez
DG
Lung Transplant Department, Hospital Universitario Puerta de Hierro, Madrid, Spain. dgavm@yahoo.es <dgavm@yahoo.es>
Marcos
Roberto
R
Laporta
Rosalía
R
Mora
Gema
G
García-Gallo
Cristina
C
Gámez
Pablo
P
Córdoba
Mar
M
Moradiellos
Javier
J
Ussetti
Piedad
P
Carreño
María C
MC
Núñez
José R
JR
Calatayud
Joaquín
J
Del Río
Francisco
F
Varela
Andrés
A
D000328:Adult; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome