title: Radiological Analysis of Unused Donor Lungs: A Tool to Improve Donor Acceptance for Transplantation?
abstract: Despite donor organ shortage, a large proportion of possible donor lungs are declined for transplantation. Criteria for accepting/declining lungs remain controversial because of the lack of adequate tools to aid in decision-making. We collected, air-inflated, and froze a large series of declined/unused donor lungs and subjected these lung specimens to CT examination. Affected target regions were scanned by using micro-CT. Lungs from 28 donors were collected. Two lungs were unused, six were declined for non-allograft-related reasons (collectively denominated nonallograft declines, n = 8), and 20 were declined because of allograft-related reasons. CT scanning demonstrated normal lung parenchyma in only four of eight nonallograft declines, while relatively normal parenchyma was found in 12 of 20 allograft-related declines. CT and micro-CT examinations confirmed the reason for decline in most lungs and revealed unexpected (unknown from clinical files or physical inspection) CT abnormalities in other lungs. CT-based measurements showed a higher mass and density in the lungs with CT alterations compared with lungs without CT abnormalities. CT could aid in the decision-making to accept or decline donor lungs which could lead to an increase in the quantity and quality of lung allografts.
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: S E
authors.initials: SE
authors.lastname: Verleden
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.|Department of Anesthesiology, UZ Leuven, Leuven, Belgium.
authors.forename: A
authors.identifier: http://orcid.org/0000-0001-6123-0908
authors.initials: A
authors.lastname: Martens
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.|Department of Anesthesiology, UZ Leuven, Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Ordies
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: T
authors.initials: T
authors.lastname: Heigl
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Bellon
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Vandermeulen
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Van Herck
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Sacreas
authors.affiliation: Departement of Radiology, UZ Leuven, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Verschakelen
authors.affiliation: Departement of Radiology, UZ Leuven, Leuven, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Coudyzer
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.|Department of Thoracic Surgery, UZ Gasthuisberg, Leuven, Belgium.
authors.forename: D E
authors.initials: DE
authors.lastname: Van Raemdonck
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Vos
authors.affiliation: Department of Pathology, UZ Gasthuisberg, Leuven, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Weynand
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: G M
authors.initials: GM
authors.lastname: Verleden
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Vanaudenaerde
authors.affiliation: Lung Transplant Unit, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.|Department of Respiratory Disease, UZ Leuven, Leuven, Belgium.|Department of Anesthesiology, UZ Leuven, Leuven, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Neyrinck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016040:Lung Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D040841:Resource Allocation; D012189:Retrospective Studies; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: clinical research/practice; diagnostic techniques and imaging: computed tomography; donors and donation: donor evaluation; donors and donation: extended criteria; lung transplantation/pulmonology; organ procurement and allocation