title: Lung donor treatment protocol in brain dead-donors: A multicenter study.
abstract: BACKGROUND
  The shortage of lung donors for transplantation is the main limitation among patients awaiting this type of surgery. We previously demonstrated that an intensive lung donor-treatment protocol succeeded in increasing the lung procurement rate. We aimed to validate our protocol for centers with or without lung transplant programs.
  
  
  METHODS
  A quasi-experimental study was performed to compare lung donor rate before (historical group, 2010 to 2012) and after (prospective group, 2013) the application of a lung management protocol for donors after brain death (DBDs) in six Spanish hospitals. Lung donor selection criteria remained unchanged in both periods. Outcome measures for lung recipients were early survival and primary graft dysfunction (PGD) rates.
  
  
  RESULTS
  A total of 618 DBDs were included: 453 in the control period and 165 in the protocol period. Donor baseline characteristics were similar in both periods. Lung donation rate in the prospective group was 27.3%, more than twice that of the historical group (13%; p < 0.001). The number of lungs retrieved, grafts transplanted, and transplants performed more than doubled over the study period. No differences in early recipients' survival between groups were observed (87.6% vs. 84.5%; p = 0.733) nor in the rate of PGD.
  
  
  CONCLUSIONS
  Implementing our intensive lung donor-treatment protocol increases lung procurement rates. This allows more lung transplants to be performed without detriment to either early survival or PGD rate.
authors.affiliation: Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, Santander. Electronic address: eminambres@yahoo.es.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Miñambres
authors.affiliation: Service of Intensive Care, University Hospital Virgen de las Nieves, Granada.
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Pérez-Villares
authors.affiliation: Service of Intensive Care, University Hospital Doce de Octubre, Madrid.
authors.forename: Mario
authors.initials: M
authors.lastname: Chico-Fernández
authors.affiliation: Service of Intensive Care, University Hospital de Burgos, Burgos.
authors.forename: Arturo
authors.initials: A
authors.lastname: Zabalegui
authors.affiliation: Service of Intensive Care, University Hospital Reina Sofía, Cordoba.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Dueñas-Jurado
authors.affiliation: Service of Intensive Care, University Hospital Germans Trias i Pujol, Badalona.
authors.forename: Maite
authors.initials: M
authors.lastname: Misis
authors.affiliation: Service of Intensive Care, Complexo Hospitalario Universitario A, Coruña, Coruña.
authors.forename: Fernando
authors.initials: F
authors.lastname: Mosteiro
authors.affiliation: Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid.
authors.forename: Gil
authors.initials: G
authors.lastname: Rodriguez-Caravaca
authors.affiliation: Organización Nacional de Trasplantes, Madrid, Spain.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Coll
mesh_terms: D000328:Adult; D000368:Aged; D001926:Brain Death; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D011446:Prospective Studies; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000379:methods*; D066027:Transplant Recipients / Q000706:statistics & numerical data*
keywords: brain-dead donor; donor treatment; lung donor; multicenter study; outcome; primary graft dysfunction; protocol