Extended donor criteria in lung transplantation.
OBJECTIVE
Despite improvements in respiratory care and lung transplant organ allocation algorithms, waiting lists continue to grow worldwide. Attempts at improving organ donation rates have generally had little impact on the increase in the number of transplants performed. Improved use of the available pool of cadaveric organ donors, therefore, represents one of few immediately available strategies to alleviate organ shortages.


RESULTS
The once-strict lung donor selection criteria have, of necessity, been relaxed and, in many instances, this situation has been to no apparent detrimental effect on posttransplant outcome. There is, however, some evidence that extension of donor acceptability in some respects leads to poorer early outcomes, mainly by increasing the rate of early graft dysfunction. The extension of selection criteria to allow the maximum number of safe lung transplants, coupled with aggressive and appropriate donor management is, therefore, of particular current relevance to the lung transplantation community.


CONCLUSIONS
Although the available evidence for and against the commonly used lung donor selection criteria leaves many questions unanswered, it can help decrease the large number of uncertainties that be falls the practice of lung donor selection and recipient matching.
Botha
Phil
P
Department of Cardiopulmonary Transplantation, Freeman Hospital, Newcastle upon Tyne, United Kingdom. P.Botha@ncl.ac.uk
D000367:Age Factors; D002102:Cadaver; D050377:Cold Ischemia / Q000009:adverse effects; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016040:Lung Transplantation / Q000009:adverse effects; D018579:Patient Selection; D011659:Pulmonary Gas Exchange; D011859:Radiography; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement; D014850:Waiting Lists; D052096:Warm Ischemia / Q000009:adverse effects