title: [Lung transplantation with uncontrolled non-heart-beating donors. Transplantation. Donor prognostic factor and immediate evolution post transplant].
abstract: BACKGROUND
  Uncontrolled donation after cardiac death (DACD) has become an alternative to lung transplantation with encephalic-death donation. The main objective of this study is to describe the incidence of clinically relevant events in the period of thirty days after lung transplant with uncontrolled DACD and the influence of factors depending on the donor and donation process as well.
  
  
  METHODS
  Historical cohort study of 33 lung transplant receivers at Hospital Puerta de Hierro and Hospital Marqués de Valdecilla with 32 DACD from Hospital Clínico San Carlos from 2002 to 2008. We studied surgical and medical complications, primary graft dysfunction, acute rejection, pneumonia and mortality. We made an evaluation of the donor characteristics and donation procedure times (minutes).
  
  
  RESULTS
  Median age of recipients was 50.5 years (interquartile range, 38.5-58). There were 28 males and 5 females. Cumulative incidence of events in the first month was: pneumonia 10 (31.3%); primary graft dysfunction 15 (46.9%); rejection 12 (37.5%); mortality 4 (12.1%); medical complications 25 (78.1%); and surgical complications 18 (56.3%). Median time of cardiac arrest was higher in those who presented pneumonia (15 vs. 7.5; p = 0.027). Median time of cold ischemia was higher in those who presented surgical complications and mortality (436 vs. 343.5; p = 0.04; 505 vs. 410; p = 0.033, respectively), and median of total ischemia times were longer in the recipients who died (828 vs. 695; p = 0.036).
  
  
  CONCLUSIONS
  Uncontrolled DACD are a valid alternative for expanding the donor pool in order to mitigate the current shortage of lungs that are valid for transplantation. The incidence of complications is comparable with published data in the literature.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Clínico San Carlos, Madrid, España. cancabrilla@hotmail.com
authors.forename: Diego A
authors.initials: DA
authors.lastname: Rodríguez
authors.forename: Francisco
authors.initials: F
authors.lastname: Del Río
authors.forename: Manuel E
authors.initials: ME
authors.lastname: Fuentes
authors.forename: Sara
authors.initials: S
authors.lastname: Naranjo
authors.forename: Javier
authors.initials: J
authors.lastname: Moradiellos
authors.forename: David
authors.initials: D
authors.lastname: Gómez
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Rubio
authors.forename: Elpidio
authors.initials: E
authors.lastname: Calvo
authors.forename: Andrés
authors.initials: A
authors.lastname: Varela
mesh_terms: D000208:Acute Disease; D000328:Adult; D001926:Brain Death; D050377:Cold Ischemia; D003643:Death; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006323:Heart Arrest; D006801:Humans; D016040:Lung Transplantation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D055031:Primary Graft Dysfunction / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D014019:Tissue Donors / Q000145:classification; D016896:Treatment Outcome