title: Short- and Long-term Outcomes After Lung Transplantation From Circulatory-Dead Donors: A Single-Center Experience.
abstract: Donation after cardiac death (DCD) to overcome the donor organ shortage is well accepted in the clinical setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown.
  
  
  
  In this retrospective study, DCD LTx recipients (n = 59) were compared with a cohort of donation after brain death (DBD) LTx recipients (n = 331) transplanted between February 2007 and September 2013; follow-up was until January 1, 2016. Short-term (duration of mechanical ventilation, intensive care unit stay, hospital stay, and highest primary graft dysfunction score within 72 hours) and long-term (chronic lung allograft dysfunction-free and overall survival) follow-up were compared over a median follow-up of 50.5 (±3.7) months for DCD and 66.8 (±1.5) months for DBD.
  
  
  
  There were no differences between groups with regard to patient characteristics: age (P = 0.78), underlying disease (P = 0.30) and type of type of LTx (P = 0.10), except sex where more males were transplanted with a DCD donor (62.7%) vs (48.3%, P = 0.048). There was no difference in time on mechanical ventilation (P = 0.59), intensive care unit stay (P = 0.74), highest primary graft dysfunction score (P = 0.67) and hospital stay (P = 0.99). Moreover, chronic lung allograft dysfunction-free (P = 0.86) and overall survival (P = 0.15) did not differ between the DBD and DCD groups.
  
  
  
  In our experience, both short- and long-term outcomes in DCD lung recipients are comparable to that of DBD lung recipients. Therefore, DCD LTx can be considered a safe strategy that significantly increased our transplant activity.
authors.affiliation: 1 Division of Respiratory Diseases, Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven/UZ Leuven, Leuven, Belgium. 2 Department of Anesthesiology and Algology, KU Leuven/UZ Leuven, Leuven, Belgium. 3 Department of Thoracic Surgery, KU Leuven/UZ Leuven, Leuven, Belgium.
authors.forename: David
authors.initials: D
authors.lastname: Ruttens
authors.forename: An
authors.initials: A
authors.lastname: Martens
authors.forename: Sofie
authors.initials: S
authors.lastname: Ordies
authors.forename: Stijn E
authors.initials: SE
authors.lastname: Verleden
authors.forename: Arne P
authors.initials: AP
authors.lastname: Neyrinck
authors.forename: Robin
authors.initials: R
authors.lastname: Vos
authors.forename: Marc Collado
authors.initials: MC
authors.lastname: Boada
authors.forename: Bart M
authors.initials: BM
authors.lastname: Vanaudenaerde
authors.forename: Geert M
authors.initials: GM
authors.lastname: Verleden
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Raemdonck
mesh_terms: D064591:Allografts; D001530:Belgium; D001926:Brain Death; D002423:Cause of Death; D018572:Disease-Free Survival; D046148:Donor Selection; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000209:etiology; D012121:Respiration, Artificial; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome