Donor Evaluation for Lung Transplantation in Korea

• Published in: Transplantation proceedings Vol. 44; no. 4; pp. 870 - 874
• Main Authors: Paik, H.C, Haam, S.J, Lee, D.Y, Yi, G.J, Song, S.W, Kim, Y.T, Kang, C.H, Kim, K.M, Park, S.I, Jheon, S.H
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01-05-2012; Elsevier
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Child; Donor Selection; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Lung Diseases - mortality; Lung Diseases - surgery; Lung Transplantation - adverse effects; Lung Transplantation - mortality; Male; Medical sciences; Middle Aged; Republic of Korea; Retrospective Studies; Risk Assessment; Risk Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue Donors - supply & distribution; Tissue, organ and graft immunology; Treatment Outcome; Waiting Lists - mortality; Young Adult; Asia; Korea; Republic of Korea; Suboptimal donor; Human; Medicine; Evaluation; Treatment; Surgery; Lung; Graft; Transplantation; Homotransplantation; Respiratory system
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.12.060

Abstract Lung transplantation for end-stage lung disease results in prolonged survival and improved pulmonary function. However, the shortage of donor lungs has been a major limiting factor in Korea. We sought to investigate the number and utilization of donor lungs by the five institutions performing LTx in Korea, retrospectively reviewing outcomes of organs registered in the Korean Network for Organ Sharing from January to December, 2010. Lungs were offered from 270 brain-dead patients (189 males and 81 females) of mean age of 45.2 ± 14.2 years (range, 12 to 77 years). The most common cause of brain death was hemorrhage (n = 219, 81%). Only 18 (6.7%) donor lungs were used, which was low compared with kidney (93.3%), liver (86.3%), heart (26.7%), and pancreas (11.1%) use. The mean age of donors of transplanted lungs was 35.7 years (range, 14 to 51 years) compared with 45.9 years for other organs ( P = .003). The characteristics of utilized donor lungs were: mean partial pressure of oxygen (PaO2 ), 300.9 mm Hg; mean smoking history, as 2.7 pack-years; and mean body mass index, 21.2 kg/m2 . The causes of refusal were medical ineligibility (n = 129) including poor PaO2 , abnormal chest x-ray, long smoking history, older age (n = 46), no properly matched recipient (n = 46), unknown (n = 17), and family withdrawal (n = 14). Only 8 (33.3%) were transplanted from standard criteria and 10 from the lungs that did not satisfy these criteria. An efficient utilization system is needed to improve lung transplantations.