Microbial Pattern of BronchoAlveolar Lavage in Brain Dead Donors

Abstract Background We assessed bronchoalveolar lavage (BAL) cultures of brain dead donors seeking to achieve better donor management and decrease transplant complications. Determining the most common source of some postoperative infections causing morbidity and mortality among lung recipients would...

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Published in:	Transplantation proceedings Vol. 43; no. 2; pp. 422 - 423
Main Authors:	Shafaghi, S, Abassi Dezfuli, A, Makki, S.S.M, Marjani, M, Mobarhan, M, Ghandchi, G, Khoddami-Vishteh, H.R, Ghorbani, F, Najafizadeh, K
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Amsterdam Elsevier Inc 01-03-2011 Elsevier
Subjects:	Adolescent Adult Biological and medical sciences Brain Death Bronchoalveolar Lavage Fluid - microbiology Bronchoscopy - methods Female Fundamental and applied biological sciences. Psychology Fundamental immunology Humans Lung - microbiology Lung Transplantation - methods Male Medical sciences Oxygen - chemistry Pneumonia - prevention & control Postoperative Complications Prospective Studies Radiography, Thoracic - methods Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Tissue, organ and graft immunology Suboptimal donor Human Medicine Treatment Bronchoalveolar lavage Surgery Brain death Graft Transplantation
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Summary:	Abstract Background We assessed bronchoalveolar lavage (BAL) cultures of brain dead donors seeking to achieve better donor management and decrease transplant complications. Determining the most common source of some postoperative infections causing morbidity and mortality among lung recipients would help to reach this goal. Materials and Methods This prospective study was performed on 80 brain dead donors from August 2008 to August 2009. Donors with partial pressure of arterial O2 to the fraction of inspired O2 (PaO2 /FIO2 ) >300 mm Hg and a normal chest x-ray underwent bronchoscopy to obtain a BAL. Findings The mean donor age was 30 ± 14 years and 50 (63%) were males with 21 (26%) showing a positive history for smoking and 32 (40%) with turbid tracheal secretions. Chest x-ray was abnormal in 49 (61%). Positive culture BAL results were observed among 30 (38%) patients: there were 17 (90%) bacterial and 6 (22%) fungal. Finally, 16 donors (20%) were considered suitable lung donors, allowing 10 lung transplantations. Conclusion Only 20% of donors had acceptable lungs for transplantation. The high rates of positive bacterial and fungal BAL cultures in donors suggest the need for more aggressive critical care management and antibiotic therapy which may be beneficial to prevent future infections in recipients. Further prospective studies are needed to assess the correlation between donor BAL results and posttransplant morbidity and mortality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0041-1345 1873-2623
DOI:	10.1016/j.transproceed.2011.01.053