Microbial Pattern of BronchoAlveolar Lavage in Brain Dead Donors

• 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
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.01.053

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.