title: Defining an extended criteria donor lung: an empirical approach based on the Eurotransplant experience.
abstract: The aim of this study was to design and validate a lung donor score that reflects experts' perceived risk of allograft failure. All lung donors reported to Eurotransplant from 1999 to 2007 [N=6080] were used to create a lung donor score. Based on observed discard rates and using multivariate regression, points were assigned for six preprocurement donor variables. Donors reported in 2008 were used to validate the score [N=751]. All the six factors significantly predicted discard; as an example, the following donor with points: age 55-59years: 2; compromised history: 4; smoking: 2; shadow on chest X-ray: 2; purulent secretion during bronchoscopy: 2; and Pao(2) /Fio(2) ratio below 300mmHg: 3. Discard rates for donors with a lung donor score of 6 points (class 1) was 18%, while 36% and 54% of the donors with a score of 7-8 (class 2) and 9+(class 3) were discarded (P<0.001), respectively. In addition, the donor lung score was significantly associated with 1-year survival: class 1: 91%; class 2: 80%; and class 3: 72% (P=0.017). The lung donor score accurately reflects the likelihood of organ acceptance and predicts patient mortality, and its application at time of donor reporting may facilitate donor risk assessment and patient selection.
authors.affiliation: Eurotransplant International Foundation Leiden, the Netherlands. JSMITS@eurotransplant.org
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Smits
authors.forename: Wim
authors.initials: W
authors.lastname: van der Bij
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Raemdonck
authors.forename: Erwin
authors.initials: E
authors.lastname: de Vries
authors.forename: Axel
authors.initials: A
authors.lastname: Rahmel
authors.forename: Guenther
authors.initials: G
authors.lastname: Laufer
authors.forename: Michel
authors.initials: M
authors.lastname: De Pauw
authors.forename: Bruno
authors.initials: B
authors.lastname: Meiser
mesh_terms: D000328:Adult; D000367:Age Factors; D002102:Cadaver; D005060:Europe / Q000453:epidemiology; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D016040:Lung Transplantation / Q000592:standards*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D018579:Patient Selection; D012907:Smoking; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000592:standards*
chemical_list: D010100:Oxygen