title: Development of a non-heart-beating donor program and results after the first year.
abstract: Our lung transplant unit began activity in October 2008. We have performed 37 lung transplants with a hospital mortality of 2.7% (n = 1). The need for a greater number of donors and the presence of an already existent non-heart-beating donor (NHBD) program for abdominal grafts and tissues encouraged us to consider assessing lung grafts from these donors. It was necessary to develop a new multiorgan preservation methodology, "bithermia preservation." The clinical experience with which during the first year June 2010 to July 2011, including 15 NHBDs is presented herein. The chest x-ray was normal in 6 donors (40%) and 7 had pulmonary infiltrates. Bronchoscopy was normal in 8 donors (53%) but 3 had abundant bleeding airway secretions and signs of bronchoaspiration. Preservation procedures were performed in 6 donors. Pulmonary functional evaluation in 4 donors showed gas measurements to be adequate in 75% of cases. Three double-lung grafts were judged to be valid for implantation, among which we performed 3 lung transplantations, 1 bilateral and 2 unilaterals, while 2 grafts were offered to the National Transplant Organization for other units. No transplant suffered primary graft dysfunction; all 3 showed excellent function allowing early extubation in 2 cases. There was no in-hospital mortality. All 3 patients are alive and leading normal lives; none has bronchiolitis obliterans syndrome. In conclusion, the "bithermia preservation" methodology achieved adequate lung preservation in NHBDs, allowing liver, kidneys, and lungs to be obtained from the same donor.
authors.affiliation: Department of Thoracic Surgery, Hospital 12 de Octubre, Madrid, Spain. jcmenesesp@gmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Meneses
authors.forename: P
authors.initials: P
authors.lastname: Gámez
authors.forename: A
authors.initials: A
authors.lastname: Mariscal
authors.forename: C
authors.initials: C
authors.lastname: Marrón
authors.forename: V
authors.initials: V
authors.lastname: Díaz-Hellín
authors.forename: M
authors.initials: M
authors.lastname: Cortes
authors.forename: A
authors.initials: A
authors.lastname: de Pablo
authors.forename: E
authors.initials: E
authors.lastname: Lopez
authors.forename: V
authors.initials: V
authors.lastname: Perez
authors.forename: O
authors.initials: O
authors.lastname: Gonzalez
authors.forename: L
authors.initials: L
authors.lastname: Juarros
authors.forename: I
authors.initials: I
authors.lastname: Martinez
authors.forename: F
authors.initials: F
authors.lastname: Hermoso
authors.forename: R
authors.initials: R
authors.lastname: Avila
authors.forename: M
authors.initials: M
authors.lastname: Zuluaga
authors.forename: J L M
authors.initials: JL
authors.lastname: de Nicolás
mesh_terms: D000328:Adult; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D019188:Organ Preservation Solutions; D014019:Tissue Donors
chemical_list: D019188:Organ Preservation Solutions