title: Lung transplantation from donation after cardiocirculatory death: a systematic review and meta-analysis.
abstract: BACKGROUND
  Lung transplantation (LTx) can extend life expectancy and enhance the quality of life for select patients with end-stage lung disease. In the setting of donor lung shortage and waiting list mortality, the interest in donation after cardiocirculatory death (DCD) is increasing. We performed a systematic review and meta-analysis to compare outcomes between DCD and conventional donation after brain death (DBD).
  
  
  METHODS
  PubMed, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and ClinicalTrials.gov were searched. We identified original research studies with 1-year post-transplant survival data involving >5 DCD transplants. We performed meta-analyses examining 1-year survival, primary graft dysfunction, and acute rejection after LTx.
  
  
  RESULTS
  We identified 519 citations; 11 observational cohort studies met our inclusion criteria for systematic review, and 6 met our inclusion criteria for meta-analysis. There were no differences found in 1-year mortality after LTx between DCD and DBD cohorts in individual studies or in the meta-analysis (DCD [n = 271] vs DBD [n = 2,369], relative risk [RR] 0.88, 95% confidence interval [CI] 0.59-1.31, p = 0.52, I(2) = 0%). There was also no difference between DCD and DBD in a pooled analysis of 5 studies reporting on primary graft dysfunction (RR 1.09, 95% CI 0.68-1.73, p = 0.7, I(2) = 0%) and 4 studies reporting on acute rejection (RR 0.72, 95% CI 0.49-1.05, p = 0.09, I(2) = 0%).
  
  
  CONCLUSIONS
  Survival after LTx from DCD is comparable to survival after LTx from DBD in observational cohort studies. DCD appears to be a safe and effective method to expand the donor pool.
authors: Department of Medicine, University of Iowa, Iowa City, Iowa.
authors: Dustin
authors: D
authors: Krutsinger
authors: Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, Maryland.
authors: Robert M
authors: RM
authors: Reed
authors: Hardin Library for the Health Sciences, University of Iowa, Iowa City, Iowa.
authors: Amy
authors: A
authors: Blevins
authors: Department of Surgery, Washington University, St. Louis, Missouri.
authors: Varun
authors: V
authors: Puri
authors: Division of Cardiothoracic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors: Nilto C
authors: NC
authors: De Oliveira
authors: Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, London, United Kingdom.
authors: Bartlomiej
authors: B
authors: Zych
authors: Department of Thoracic Surgery, Dr. Korst Schmidt Klinik, Wiesbaden, Germany.
authors: Servet
authors: S
authors: Bolukbas
authors: Department of Thoracic Surgery and Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium.
authors: Dirk
authors: D
authors: Van Raemdonck
authors: Lung Transplant Service, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Australia.
authors: Gregory I
authors: GI
authors: Snell
authors: Department of Medicine, University of Iowa, Iowa City, Iowa; Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa, Iowa City, Iowa. Electronic address: michael-eberlein@uiowa.edu.
authors: Michael
authors: M
authors: Eberlein
mesh_terms: D006323:Heart Arrest; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods*
keywords: cardiocirculatory death; circulatory determination of death; donation after cardiac death; lung transplantation; non–heart-beating donor