title: Lung donation and causes behind its failure: a single-center experience.
abstract: BACKGROUND
  Brain-dead patients are almost the only source of organs for lung transplantation, and lungs fall within the area of the least harvested organs. As a result, maintaining the highest possible harvest rate is a must for the lung transplantation system. In the present study, the harvest rate of lungs and also the causes of failure to donate the lungs is reported for brain-dead patients in our organ procurement unit.
  
  
  METHODS
  After going through the brain-death database at our organ procurement unit between 2004 and 2008, we included all 93 brain deaths in this hospital. The lung donation rate was reviewed to examined the causes for failure to donate lungs.
  
  
  RESULTS
  From the total brain-dead patients registered in the database, only 4 (4.6%) patients donated their lungs. The causes of failure to donate a lung were not suitable lungs among 78 (83.8%) because they had an unacceptable oxygen challenge test results (<300 mm Hg). Another 11 patients had acceptable oxygen challenge test results, but donation failed in their case as well due to most frequently to pulmonary aspiration.
  
  
  CONCLUSIONS
  In this center, only a small percentage of lungs are appropriate for harvest in brain-dead patients, because many patients' lungs do not meet the criteria with unacceptable oxygen challenge test results. Patients with proper test results may fail to donate lungs due to pulmonary aspiration. More aggressive care of the patients may have an important role in keeping them in good condition and helping to preserve the organs for harvest. For this purpose, further training of intensive care unit staff and physicians are among the suggested steps to enhance the quality of care, which in turn can maximize the lung harvest rate.
authors.affiliation: Lung Transplantation Research Center, National Research Institute of TB and Lung Disease, Shaheed Beheshti Medical University, Tehran, Iran. katynajafi@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Najafizadeh
authors.forename: M B
authors.initials: MB
authors.lastname: Shadmehr
authors.forename: A
authors.initials: A
authors.lastname: Daneshvar
authors.forename: M
authors.initials: M
authors.lastname: Malekmohammad
authors.forename: M
authors.initials: M
authors.lastname: Arab
authors.forename: Z H
authors.initials: ZH
authors.lastname: Ahmadi
authors.forename: Sh
authors.initials: Sh
authors.lastname: Shafaghi
authors.forename: F
authors.initials: F
authors.lastname: Ghorbani
authors.forename: S
authors.initials: S
authors.lastname: Assari
authors.forename: M
authors.initials: M
authors.lastname: Moghani-Lankarani
mesh_terms: D000293:Adolescent; D000328:Adult; D001926:Brain Death; D002423:Cause of Death; D002648:Child; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000706:statistics & numerical data; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult