Lung transplantation and donation after cardiac death: a single center experience.
BACKGROUND
Lung donation after cardiac death (DCD) can enlarge the donor pool. Single-center reports have shown comparable outcomes after lung transplantation using conventional donors versus DCD in small numbers of patients.


METHODS
We performed a retrospective review of DCD experience at a single lung transplant program using a prospective database.


RESULTS
Between January 2003 and April 2008, 293 lung transplantations were performed, including 11 bilateral transplantations (3.7%) using DCD lungs. Similar criteria were used to assess donor quality. The hospital mortality for DCD recipients was 2 of 11 (18%) and overall mortality was 4 of 11 (36%) by 18 months of follow-up. Seven DCD patients (64%) are alive with a median follow-up of 32 months. The DCD group was comparable to the control group in age and ischemic times. The 4 deaths, when compared with 7 DCD survivors, had longer ischemic time (293 minutes versus 232 minutes) and a higher incidence of nonlocal donors (3 of 4 versus 1 of 7).


CONCLUSIONS
At our center, early outcomes after DCD lung transplantations are somewhat inferior to those of series from other centers but approach national averages for conventional lung transplantation. Thus, DCD lung transplantation has the potential to increase the donor pool but must be offered cautiously.
Department of Surgery, Washington University, St. Louis, Missouri, USA.
Varun
V
Puri
Masina
M
Scavuzzo
Tracey
T
Guthrie
Ramsey
R
Hachem
Alexander S
AS
Krupnick
Daniel
D
Kreisel
G Alexander
GA
Patterson
Bryan F
BF
Meyers
D000328:Adult; D000368:Aged; D003643:Death; D006801:Humans; D016040:Lung Transplantation; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult