Lung donor treatment protocol in brain dead-donors: A multicenter study

• Published in: The Journal of heart and lung transplantation Vol. 34; no. 6; pp. 773 - 780
• Main Authors: Miñambres, Eduardo, MD, PhD, Pérez-Villares, Jose Miguel, MD, PhD, Chico-Fernández, Mario, MD, PhD, Zabalegui, Arturo, MD, PhD, Dueñas-Jurado, Jose María, MD, Misis, Maite, MD, PhD, Mosteiro, Fernando, MD, Rodriguez-Caravaca, Gil, MD, PhD, Coll, Elisabeth, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2015
• Subjects: Adult; Aged; Brain Death; brain-dead donor; donor treatment; Female; Graft Rejection - epidemiology; Humans; Incidence; lung donor; Lung Transplantation - mortality; Lung Transplantation - statistics & numerical data; Male; Middle Aged; multicenter study; outcome; Outcome Assessment (Health Care); Patient Selection; primary graft dysfunction; Prospective Studies; protocol; Retrospective Studies; Spain - epidemiology; Surgery; Survival Rate; Tissue and Organ Procurement - methods; Tissue Donors - statistics & numerical data; Transplant Recipients - statistics & numerical data; Spain; protocol; multicenter study; brain-dead donor; donor treatment; lung donor; outcome; primary graft dysfunction
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2014.09.024

Background The shortage of lung donors for transplantation is the main limitation among patients awaiting this type of surgery. We previously demonstrated that an intensive lung donor-treatment protocol succeeded in increasing the lung procurement rate. We aimed to validate our protocol for centers with or without lung transplant programs. Methods A quasi-experimental study was performed to compare lung donor rate before (historical group, 2010 to 2012) and after (prospective group, 2013) the application of a lung management protocol for donors after brain death (DBDs) in six Spanish hospitals. Lung donor selection criteria remained unchanged in both periods. Outcome measures for lung recipients were early survival and primary graft dysfunction (PGD) rates. Results A total of 618 DBDs were included: 453 in the control period and 165 in the protocol period. Donor baseline characteristics were similar in both periods. Lung donation rate in the prospective group was 27.3%, more than twice that of the historical group (13%; p < 0.001). The number of lungs retrieved, grafts transplanted, and transplants performed more than doubled over the study period. No differences in early recipients’ survival between groups were observed (87.6% vs 84.5%; p = 0.733) nor in the rate of PGD. Conclusion Implementing our intensive lung donor-treatment protocol increases lung procurement rates. This allows more lung transplants to be performed without detriment to either early survival or PGD rate.