title: An intensive lung donor treatment protocol does not have negative influence on other grafts: a multicentre study.
abstract: OBJECTIVE
  Competing requirements for organ perfusion may call for antagonistic strategies such as fluid replacement or high positive end-expiratory pressure. We recently proposed an intensive lung donor treatment protocol that nearly tripled lung procurement rates and validated it in a multicentre study. The next step was to evaluate the impact of our proposal on the other organ grafts recovered from lung donors and on the recipients' outcome after transplantation of those grafts.
  
  
  METHODS
  A quasi-experimental study was conducted in six Spanish hospitals during 2013 (2010-12 was historical control). Organ donor management was led by a trained and experienced intensive care staff.
  
  
  RESULTS
  A total of 618 actual donors after brain death (DBDs) were included, 453 DBDs in the control period (annual average 151) and 165 in the protocol period. No baseline differences were found between the periods. Heart, liver, kidney and pancreas retrieval rates were similar in both periods, and heart, liver, kidney and pancreas recipients' survival at 3 months showed no differences between both periods.
  
  
  CONCLUSIONS
  Our lung donor treatment protocol is safe for other grafts obtained from donors undergoing these procedures with the aim of increasing lungs available for transplantation. It has no negative impact on the recovery rates of other grafts or on early survival of heart, liver, pancreas or kidney recipients.
authors.affiliation: Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain 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, Spain.
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Pérez-Villares
authors.affiliation: Service of Intensive Care, University Hospital Doce de Octubre, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Terceros-Almanza
authors.affiliation: Service of Intensive Care, University Hospital Reina Sofía, Cordoba, Spain.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Dueñas-Jurado
authors.affiliation: Service of Intensive Care, University Hospital General de Burgos, Burgos, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Zabalegui
authors.affiliation: Service of Intensive Care, University Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Misis
authors.affiliation: Transplant Coordination Unit, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Bouza
authors.affiliation: Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Ballesteros
authors.affiliation: Organización Nacional de Trasplantes (ONT), Madrid, Spain.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Coll
mesh_terms: D000328:Adult; D000368:Aged; D001926:Brain Death; D002985:Clinical Protocols; D005260:Female; D006085:Graft Survival; D006801:Humans; D016040:Lung Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data
keywords: Brain-dead donor; Lung donor; Multicentre study; Protocol