title: Lung Donation After Controlled Circulatory Determination of Death: A Review of Current Practices and Outcomes.
abstract: BACKGROUND
  Since the first reported series in 1995, transplantation of lungs recovered through donation after circulatory determination of death (DCDD) has steadily increased. In some European and Australian centers, controlled DCDD accounts for 15% to 30% of all transplanted lungs. Several transplant centers have reported early and midterm outcomes similar to those associated with the use of donors after brain death. Despite these encouraging reports, less than 2% of all lung transplants in the United States are performed using donors after circulatory determination of death.
  
  
  METHODS
  An electronic search from January 1990 to January 2014 was performed to identify series reporting lung transplant outcomes using controlled DCDD. Data from these publications were analyzed in terms of donor characteristics, donation after circulatory determination of death protocols, recipients' characteristics, and early and midterm outcomes.
  
  
  RESULTS
  Two hundred twenty-two DCDDs were transplanted into 225 recipients. The rate of primary graft dysfunction grade 3 ranged from 3% to 36%. The need for extracorporeal membrane oxygenation support after transplantation ranged from 0% to 18%. The average intensive care unit stay ranged from 4 to 8.5 days and the average hospital stay ranged from 14 to 35 days. Thirty-day mortality ranged from 0% to 11% and 1-year survival from 88% to 100%.
  
  
  CONCLUSIONS
  Under clinical protocols developed and strictly applied by several experienced lung transplant programs, lungs from controlled DCDD have produced outcomes very similar to those observed with brain death donors.
authors: Division of Cardiac Surgery, University of Maryland, Baltimore, Maryland, United States. Electronic address: psanchez@smail.umaryland.edu.
authors: P G
authors: PG
authors: Sanchez
authors: University of Maryland School of Medicine, Baltimore, Maryland, United States.
authors: M
authors: M
authors: Rouse
authors: University of Maryland School of Medicine, Baltimore, Maryland, United States.
authors: D L
authors: DL
authors: Pratt
authors: Division of Cardiac Surgery, University of Maryland, Baltimore, Maryland, United States.
authors: Z N
authors: ZN
authors: Kon
authors: Division of Cardiac Surgery, University of Maryland, Baltimore, Maryland, United States.
authors: R N
authors: RN
authors: Pierson
authors: Division of Cardiac Surgery, University of Maryland, Baltimore, Maryland, United States.
authors: K
authors: K
authors: Rajagopal
authors: Department of Medicine, University of Maryland, Baltimore, Maryland, United States.
authors: A T
authors: AT
authors: Iacono
authors: Division of Cardiac Surgery, University of Maryland, Baltimore, Maryland, United States.
authors: S M
authors: SM
authors: Pham
authors: Division of Cardiac Surgery, University of Maryland, Baltimore, Maryland, United States.
authors: B P
authors: BP
authors: Griffith
mesh_terms: D001926:Brain Death / Q000175:diagnosis*; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D055031:Primary Graft Dysfunction / Q000517:prevention & control; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration*