title: Early lung retrieval from traumatic brain-dead donors does not compromise outcomes following lung transplantation.
abstract: OBJECTIVE
  To determine whether lung retrieval from traumatic donors performed within 24 h of brain death has a negative impact on early graft function and survival after lung transplantation (LT), when compared with those retrieved after 24 h.
  
  
  METHODS
  Review of lung transplants performed from traumatic donors over a 17-year period. Recipients were distributed into two groups: transplants from traumatic donor lungs retrieved within 24 h of brain death (Group A), and transplants from traumatic donor lungs retrieved after 24 h of brain death (Group B). Demographic data of donors and recipients, early graft function, perioperative complications and mortality were compared between both groups.
  
  
  RESULTS
  Among 356 lung transplants performed at our institution, 132 were from traumatic donors (70% male, 30% female). Group A: 73 (55%); Group B: 59 (45%). There were 53 single, 77 double, and 2 combined LT. Indications were emphysema in 41 (31%), pulmonary fibrosis in 31 (23%), cystic fibrosis in 38 (29%), bronchiectasis in 9 (7%) and other indications in 13 patients (10%). Donor and recipient demographic data, need or cardiopulmonary bypass, postoperative complications and Intensive Care Unit and hospital stay did not differ between groups. Primary graft dysfunction (A vs B): 9 (16%) vs 13 (26%) P = 0.17. PaO2/FiO2 24 h post-transplant (A vs B): 303 mmHg vs 288 mmHg (P = 0.57). Number of acute rejection episodes (A vs B): 0.93 vs 1.49 (P = 0.01). Postoperative intubation time (A vs B): 99 vs 100 h (P = 0.99). 30-day mortality (A vs B): 7 (10%) vs 2 (3.5%) (P = 0.13). Freedom from bronchiolitis obliterans syndrome (A vs B): 82, 72, 37, 22 vs 78, 68, 42, 15%, at 3, 5, 10 and 15 years, respectively (P = 0.889). Survival (A vs B): 65, 54, 46, 42 and 27 vs 60, 50, 45, 43 and 29% at 3, 5, 7, 10 and 15 years, respectively (P = 0.937).
  
  
  CONCLUSIONS
  In our experience, early lung retrieval after brain death from traumatic donors does not adversely affect early and long-term outcomes after LT.
authors: Thoracic Surgery and Lung Transplantation Unit, University Hospital Reina Sofía, Córdoba, Spain. pmoreno39@gmail.com
authors: Paula
authors: P
authors: Moreno
authors: Antonio
authors: A
authors: Alvarez
authors: Jennifer
authors: J
authors: Illana
authors: Dionisio
authors: D
authors: Espinosa
authors: Carlos
authors: C
authors: Baamonde
authors: Francisco
authors: F
authors: Cerezo
authors: Francisco Javier
authors: FJ
authors: Algar
authors: Angel
authors: A
authors: Salvatierra
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001926:Brain Death; D001989:Bronchiolitis Obliterans / Q000209:etiology; D016009:Chi-Square Distribution; D003550:Cystic Fibrosis / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000601:surgery; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D011658:Pulmonary Fibrosis / Q000601:surgery; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome; D014947:Wounds and Injuries
keywords: Brain death; Lung donors; Lung injury; Lung transplantation; Primary graft dysfunction