Early outcome after lung transplantation from non-heart-beating donors is comparable to heart-beating donors.
BACKGROUND
The use of non-heart-beating donors (NHBD) to overcome organ shortage is moving into the clinic. In 2007, 5 of 51 lung transplantations (LTx) in our center were performed with lungs from controlled NHBD.


METHODS
Our aim was to describe these 5 NHBD LTx recipients and compare early outcome (<or= 6 months) with a cohort of 10 heart-beating donor (HBD) LTx recipients matched for age, gender, underlying disease, and time of surgery. Clinical outcomes were assessed, including ischemic times, gas exchange, primary graft dysfunction, time to extubation, time of discharge from intensive care unit/hospital, and pulmonary function. Airway and systematic inflammation were evaluated by bronchoalveolar lavage, total and differential cell counts, and plasma C-reactive protein levels, respectively.


RESULTS
Early outcome in the NHBD group was comparable to the HBD group at the clinical and inflammatory level. The NHBD group showed a trend for earlier extubation (p = 0.054), greater increase in forced expiratory volume in 1 second (p = 0.054), and a significantly lower number of infections (p = 0.01). The NHBD group also had lower numbers of total cells (p = 0.04) and macrophages (p = 0.03) in bronchoalveolar lavage on day 21.


CONCLUSIONS
Outcome after LTx in NHBD recipients is not inferior to HBD recipients during the first 6 months. Late results and effect on chronic rejection should be further awaited. Controlled NHBD may offer a valid source of lungs to overcome organ shortage in LTx.
De Vleeschauwer
Stéphanie
S
Laboratory of Pneumology, Kathoholieke Universiteit Leuven, Leuven, Belgium.
Van Raemdonck
Dirk
D
Vanaudenaerde
Bart
B
Vos
Robin
R
Meers
Caroline
C
Wauters
Shana
S
Coosemans
Willy
W
Decaluwe
Herbert
H
De Leyn
Paul
P
Nafteux
Philippe
P
Dupont
Lieven
L
Lerut
Toni
T
Verleden
Geert
G